title: Total Knee Arthroplasty in Hemophilic Arthropathy.
abstract: Hemophilic arthropathy of the knee is common among patients with hemophilia and is a major cause of severe joint pain and functional disability requiring total knee arthroplasty (TKA). We evaluated TKA outcomes and complications with a special focus on prosthetic survival and infection. We retrospectively reviewed the medical records of 74 patients with chronic hemophilic arthropathy of the knee treated with TKA (N = 88) over a 13-year period. The same type of implant was used in all cases. Fourteen patients had 2-stage bilateral TKAs. Mean patient age was 38.2 years (range, 24-73 years). Fourteen patients were positive for human immunodeficiency virus, and 32 for hepatitis C virus. Mean follow-up was 8 years (range, 1-13 years). The prosthetic survival rate with implant removal for any reason regarded as final endpoint was 92%. Causes of TKA failure were prosthetic joint infection (6.8%) and aseptic loosening (2.2%). Clinical outcomes of the primary TKAs in this series were good prosthetic survival and excellent pain relief. TKA infection continues to be a major concern for patients with hemophilia relative to patients without hemophilia.
authors.affiliation: Department of Orthopaedic Surgery, La Paz University Hospita-IdiPaz, Madrid, Spain. ecrmerchan@gmx.es.
authors.forename: E Carlos
authors.initials: EC
authors.lastname: Rodríguez-Merchán
mesh_terms: D000328:Adult; D000368:Aged; D019645:Arthroplasty, Replacement, Knee; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D015994:Incidence; D007592:Joint Diseases / Q000209:etiology / Q000601:surgery*; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D011379:Prognosis; D011475:Prosthesis Failure; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology; D055815:Young Adult