Revision Knee Arthroplasty in Patients with Inherited Bleeding Disorders: A Single-Center Experience
Andrzej Kotela, Magdalena Wilk-Frańczuk, Piotr Żbikowski, Paweł Łęgosz, Paweł Ambroziak, Ireneusz Kotela
(Department of Orthopaedics and Traumatology of the Musculoskeletal System, 1st Faculty of Medicine, Medical University of Warsaw, Warsaw, Poland)
Med Sci Monit 2017; 23:129-137
The results of total knee arthroplasty (TKA) in patients with inherited bleeding disorders (IBDs) are poorer when compared with those in the general population, with a notably higher risk of complications and higher revision rates. Thus, revision procedures are becoming a growing concern in this group of patients. The aim of this study was to evaluate the results of revision TKA in patients with IBD.
MATERIAL AND METHODS: A retrospective cohort study with longitudinal assessment of hemophilia patients scheduled for revision TKA between January 2010 and September 2015 was performed. The clinical status of the patients was assessed based on the Knee Society Score, and the Numeric Rating Scale was used to assess knee pain severity and patient satisfaction with the surgery. Radiological examination, post-operative complications, and reinterventions were recorded and analyzed.
RESULTS: Very good results were obtained in all patients treated for aseptic loosening of the implant. However, inferior results were found in cases with infection. All patients operated on for aseptic loosening required only single-stage TKA, whereas patients with infection underwent multiple interventions. Complications were observed only in cases with infection.
CONCLUSIONS: Our study clearly outlined the differences in results based on failure mode, with far inferior results obtained in cases with infection. Given the lack of data in this area as well as the high specificity of this population, further high-quality studies are needed.
Keywords: Arthroplasty, Replacement, Knee, Blood Coagulation Disorders, Reoperation