Functional outcome of total knee arthroplasty in patients with haemophilia

IntroductionHaemophilic arthropathy (HA) is a debilitating complication of haemophilia which leads to TKA in severe cases. AimWe conducted a prospective study of the outcome of TKA in our haemophilia cohort to define the outcomes in this population and increase the cost effectiveness of the procedure in our developing country. MethodsWe reviewed patients with haemophilia who underwent TKA between April 2010 and April 2014. Patients with at least 6 months of follow-up were included. Preoperative knee scores (KSS and WOMAC) and the scores of the quality of life were recorded. Radiographic indices were registered pre- and postoperatively. Any complications were recorded. The patients underwent TKA with medial parapatellar approach. We had a low threshold for quadriceps snip when exposure was difficult. As our routine we did not use suction drains postoperatively. ResultsWe included 83 patients (all males, 103 knees). The mean age of the patients was 35.8 years. The mean follow-up period was 45.1 months. Three patients (3.6%) had factor inhibitors. Twenty patients (24.1%) underwent bilateral simultaneous TKA. The mean admission time was 13.87 days. We had two cases of wound infection and one case of haematoma. None of our patients needed transfusion. All knee scores were significantly improved (P < 0.000). ConclusionTotal knee replacement is an effective procedure in treatment of HA. Definition of standards of care for this procedure, which are tailored for resources of a developing country, can have major impact in improving outcomes while maximizing cost effectiveness of this surgery.