Preliminary results for the use of knee mega-endoprosthesis in the treatment of musculoskeletal complications of haemophilia.
Complications of haemophilia in the knee region are rare and difficult to treat. Use of surgical treatments such as total knee arthroplasty cannot satisfactorily restore knee function in patients with these complications, which include massive haemophilic pseudotumour, fracture around the knee and haemarthrosis. To analyse the postoperative results of patients suffering from complications of haemophilia and treated with a knee mega-endoprosthesis, to discuss and compare this type of surgical management with other types of treatments used in similar cases. We retrospectively analyse the surgical results of patients who were treated with a knee mega-endoprosthesis for complications of haemophilia. Three severe haemophilic arthritic knees, of which two were combined with femoral condylar fractures, were treated in a one-stage surgery, and another two knees which presented with massive haemophilic pseudotumours and bony defects were treated in a two-stage operation. Mean age at time of surgery was 28.5 years old and mean follow-up time was 22.8 months; the mega-endoprosthesis surgery was successfully performed in four cases and the mean range of motion increased from 29.5° preoperatively to 96.75° postoperatively. The Knee society score function score value increased from 25 to 82.5. One knee was amputated because of uncontrollable recurrent haemorrhage. Roentgenograms did not show any signs of loosening of the prostheses. Use of Mega-endoprosthesis in the treatment of complications of haemophilia can offer patients suffering from massive pseudotumours with bone defect, severe contracture knee haemophilic arthritis and fractures around a haemophilic knee a viable treatment option.
Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Institute of Orthopedics and Traumatology, Shanghai, China.
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Sunnassee
Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Institute of Orthopedics and Traumatology, Shanghai, China.
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R
Wan
Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Institute of Orthopedics and Traumatology, Shanghai, China.
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Shen
Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Institute of Orthopedics and Traumatology, Shanghai, China.
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Xu
Department of Orthopedics Surgery, Louisiana State University, Health Science Center, New Orleans, USA.|Department of Orthopedics Surgery, Institute for Western Surgery, Shanghai, China.
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Southern
Department of Orthopedics, Shanghai Ruijin Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai Institute of Orthopedics and Traumatology, Shanghai, China.
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Zhang
D000293:Adolescent; D000328:Adult; D019645:Arthroplasty, Replacement, Knee; D006395:Hemarthrosis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D006467:Hemophilia A / Q000150:complications*; D002836:Hemophilia B / Q000150:complications*; D006801:Humans; D007720:Knee Prosthesis; D059352:Musculoskeletal Pain; D026741:Physical Therapy Modalities; D011182:Postoperative Care; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult
endoprosthesis; haemophilia; knee; pseudotumour; surgical treatment