The Journal of Bone and Joint Surgery, Vol 67, Issue 9 1361-1366, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
Total knee arthroplasty in hemophilia
PF Lachiewicz, AE Inglis, JN Insall, TP Sculco, MW Hilgartner and JB Bussel
Twenty-four total knee arthroplasties were performed in fourteen disabled
patients with hemophilia. The average age of the patients at operation was
thirty-five years. Twenty-one of the implants that were used were total
condylar prostheses. Using The Hospital for Special Surgery knee-rating
system after two to nine years of follow-up, the result in fifteen knees
was rated as excellent; in six, as good; and in one, as fair. Two patients
had a poor result that was attributable to late infection. Pain and
function were markedly improved, and the average gain in range of motion
was 23 degrees. Postoperative complications, in addition to the infections,
included one subcutaneous hematoma, one hemolytic anemia, and one instance
of inhibition to Factor VIII. The technical problems in treatment were
formidable. Total knee arthroplasty in a hemophiliac can be successful, but
it should be performed only with strict hematological supervision. The
surgeon should be prepared to treat many potential postoperative
complications.
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