Abstract
While satisfactory results have been reported during short-to mid-term follow-up assessments of hemophilic patients who have undergone total knee arthroplasty (TKA), limited literature focusing on long-term survival following TKA exists to date. As part of this investigation, a consecutive series of 78 TKAs in 56 patients with hemophilic arthropathy was reviewed. The mean patient age at the time of operation was 38.7 years old and the mean length of follow up was 10.2 years. Clinical and radiologic outcomes, quality of life, complications, and long-term survivorship of TKA were evaluated. At the latest point of follow up, the average American Knee Society (AKS) knee and function scores had improved from 32.1 to 85.7 points and 41.5 to 83.3 points, respectively. Moreover, the average range of motion (ROM) was significantly increased from 64.2° preoperatively to 84.2° postoperatively. The physical and mental Short Form-36 results were also significantly improved at the latest point of follow up. Postoperative complications appeared in 12 knees (15.4%). The readmission rate in the 30 days after discharge was 6.4%. Revision TKA was performed in three knees for periprosthetic joint infection (n = 2 knees) and tibial component loosening (n = 1 knee). The Kaplan–Meier 10- and 13-year prosthesis survival rates were 97.1% and 93.2%, respectively. The current study suggests that the mid-to long-term results of TKA in patients with hemophilic arthropathy are favorable, with successful long-term prosthesis survival achievable in most cases.
Highlights
End-stage hemophilic arthropathy of the knee usually leads to total knee arthroplasty (TKA) to reduce severe pain and improve function [1]
10 cases occurred during a robot TKA and two cases occurred during navigation TKA
The current study suggests that mid-to long-term results of TKA in hemophilic arthropathy are favorable with successful long-term prosthesis survival
Summary
End-stage hemophilic arthropathy of the knee usually leads to total knee arthroplasty (TKA) to reduce severe pain and improve function [1]. Several studies with short- to mid-term follow up have demonstrated promising results with high rates of satisfaction together with significant improvement in knee function and pain relief [6,7,8,9], many authors have reported relatively greater rates of early and late complications exist relative to those in nonhemophilic cohorts undergoing TKA, such as aged patients with primary osteoarthritis [10,11,12,13,14]. Studies have included only small hemophilic populations with TKA over a long period postoperation at multiple centers and there are little data available reporting long-term results in patients with hemophilia [15,16]. Meedd. a20t2a0,s9i,nxgFleORinPsEtiEtRutRiEoVnI.EWWe assessed the prosthesis survival rate at longer than 10 y2eaorf s12 after surgery
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