[Total knee arthroplasty in hemophilic arthropathy]

The case of a bilateral total knee arthroplasty in a hemophiliac patient is presented below. Postoperative blood loss, required factor substitution, complications after surgery were observed. Functional results were evaluated using the Hospital for Special Surgery Score. The pathophysiology of hemophilic arthropathy is reviewed also. The arthroplasties were performed using factor substitution and a tourniquet, posterior stabilized prosthesis was implanted on both sides. The average postoperative blood-loss was 700 ml. After the first procedure hemarthrosis occurred, other complications were not observed. Follow-up time was 164 weeks in the first case and 112 in the second. The average improvement in Hospital for Special Surgery Score was 34 points reaching 97,5 points postoperatively. Range of movement was 0-120 degrees on the right and 0-135 degrees on the left side. The authors emphasize the importance of the adequate hematological and anaesthetical background when performing surgery in a hemophiliac patient.