Minimally invasive surgery for haemophilic pseudotumour of the limbs: 28 years of experience.

Abstract

Haemophilic pseudotumour (HP) is an encapsulated haematoma in patients with haemophilia (PWH) which has a tendency to progress and produce clinical symptoms related to its anatomical location. To show the experience of one surgeon who has been using mini-invasive technique to treat pseudotumours of limbs in PWH with and without inhibitors at one centre for 28years. Thirty-three patients with 39 HP were treated. All patients had haemophilia A. Twenty-four patients had no inhibitors (72.8%), and 9 had inhibitors (27.2%). The mean follow-up was 16years (1-25). All patients had x-rays and MRIs. All of them received Buenos Aires protocol as conservative treatment for 6weeks. MRIs were repeated after 6weeks' treatment to assess response to treatment. Surgery was performed in patients who did not respond to conservative treatment. After Buenos Aires protocol, four pseudotumours did not shrink (10.24%), 33 (84.61%) shrank, and two (5.12%) healed. Thirty-seven pseudotumours had surgery, 35 pseudotumours (94.59%) healed with minimally invasive treatment, and two did not heal (5.41%). No infection was observed with this treatment. The mortality rate for the series was 0%. The minimally invasive treatment of pseudotumours was effective in 95% of the cases and resulted in no mortality in this series after 28years.