The Journal of Bone and Joint Surgery, Vol 63, Issue 5 695-701, Copyright © 1981 by Journal of Bone and Joint Surgery, Inc
Total knee arthroplasty in classic hemophilia
VM Goldberg, KG Heiple, OD Ratnoff, E Kurczynski and G Arvan
Thirteen total knee replacements of the semiconstrained type were performed
in ten patients with classic hemophilia (factor-VIII deficiency) and
followed for two to six and one-half years. The average age at operation
was twenty-seven years. Preoperatively, all patients complained of severe
pain and were markedly disabled: five required wheelchairs and five needed
crutches to walk. All patients had declared themselves willing to accept
arthrodesis as the only surgical alternative. The results of the total knee
arthroplasties, as determined by a standard knee-scoring system, were four
knees rated as excellent or good and eight rated as fair. The thirteenth
knee required an arthrodesis after a deep infection and was rated as a
failure. Pain and function were markedly improved, and no patient required
a wheelchair postoperatively. Although the postoperative knee motion was
only slightly improved, it was in a range that meant a more functional
knee. Postoperative complications included intra-articular or intramuscular
bleeding in three patients and one posterior tibial and three
peroneal-nerve palsies, one of which still was not completely resolved at
the time of writing. Total knee arthroplasty in hemophilia appears to be a
satisfactory procedure for reconstruction of the severely damaged knee when
arthrodesis is the only other acceptable alternative.
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