Elective total knee arthroplasty in haemophilic patients. Proposal for a clinical pathway.
Total knee arthroplasty (TKA) provides significant pain relief and better function in patients with end-stage haemophilic knee arthropathy. Peri- and postoperative care tends to be more complex than in non-haemophilic patients undergoing TKA and requires a multidisciplinary team approach.


OBJECTIVE
The implementation of standardized clinical pathways in non-haemophilic patients undergoing TKA has been shown to increase quality of care and to reduce postoperative complication rates. Consequently, the use of clinical pathways in haemophilic patients undergoing TKA may be beneficial to this particular subpopulation of patients.


METHODS
A clinical pathway for TKA for haemophilic patients was designed in a consensus process involving all participating departments.


RESULTS
We propose a specifically adjusted clinical pathway for TKA for haemophilic patients to show that standardization of elective orthopaedic surgery in haemophilia is feasible.


CONCLUSIONS
The authors emphasize that there are limitations on categorizing haemophilic patients and stress that individual interdisciplinary treatment should take precedence over a standardized approach.
Prof. Dr. Thomas Wallny, Orthopädie und Unfallchirurgie, Malteser Krankenhaus Von-Hompesch-Str. 1, 53123 Bonn, Tel. 02 28/64 81 90 81, Fax 02 28/648 18 66, E-mail: wallny@gmx.de.
T A
TA
Wallny
A C
AC
Strauss
G
G
Goldmann
J
J
Oldenburg
D C
DC
Wirtz
P H
PH
Pennekamp
D018771:Arthralgia / Q000175:diagnosis / Q000517:prevention & control*; D019645:Arthroplasty, Replacement, Knee / Q000592:standards*; D019091:Critical Pathways / Q000592:standards*; D017558:Elective Surgical Procedures / Q000592:standards*; D019317:Evidence-Based Medicine; D005858:Germany; D006395:Hemarthrosis / Q000150:complications / Q000175:diagnosis* / Q000601:surgery*; D006405:Hematology / Q000592:standards; D006801:Humans; D009985:Orthopedics / Q000592:standards; D017410:Practice Guidelines as Topic
Clinical pathway; haemophilia; total knee arthroplasty