Simultaneous total hip and knee arthroplasties in hemophiliacs

Kaya Biçer M. E. , Bakan Ö. M. , Vahabi A. , Şahin F. , Kavaklı R. K. , Aydoğdu S.

World Federation of Hemophilia, Virtual Summit - Connecting the Global Bleeding Disorders Community, İzmir, Türkiye, 1 - 03 Haziran 2020, cilt.26, no.32478881, ss.49

  • Cilt numarası: 26
  • Basıldığı Şehir: İzmir
  • Basıldığı Ülke: Türkiye
  • Sayfa Sayıları: ss.49


Introduction: Hemophilic patients frequently suffer from severe arthropathies involving multiple joints most of which could be only treated with arthroplasty procedures. Whenever it is possible, performing multiple operations in one session is preferred in hemophiliacs, which is cost‐effective, more tolerable for the patient since it provides a faster solution, and facilitates rehabilitation process. Aim of this study was to compare preoperative & postoperative objective & subjective measures in hemophiliacs who had simultaneous total hip (THA) and knee (TKA) arthroplasties.

Materials and Methods: Between 2002 and 2018, 45 primary TKAs (30 patients) and eight THAs (eight patients) were performed in hemophilia A patients. Five of eight THA patients had simultaneous TKAs; two patients in another session. Four simultaneous procedures were ipsilateral; one was contralateral. Mean age of patients was 50.8 ± 11.3. One patient was deceased in the early postoperative period as a result of prolonged gastrointestinal bleeding due to liver cirrhosis secondary to hepatitis C. For the rest, mean follow‐up duration was 60 months (range, 21‐123 months). Preoperative and postoperative Harris hip scores (HHS), Knee Society (KSS) Knee & Function Scores, Knee injury and Osteoarthritis Outcome Scores (KOOS), visual analogue scale (VAS) for knee pain was compared. Hospitalization duration, postoperative blood transfusion amounts was reviewed. Statistical analyses were performed using SPSS v18.

Results: Regarding subjective and objective measures, hip and knee joints were improved during the follow up (Table 1). However, due to small sample size the achievements could not be reflected in the statistical analyses. Mean hospitalization duration was 18.2 ± 4.8 days (range 13‐26). Mean amount of blood transfusion was 6.8 ± 3.49 (range 5‐13).

Conclusions: Simultaneous hip and knee arthroplasties in hemophiliacs seems to be advantageous by means of cost effectiveness, patients’ perception of the outcome and functional gains. Special attention should be paid in case of comorbid diseases to foresee potential postoperative problems.