Total Knee Arthroplasty in Hemophilic Arthropathy

Hemophilic arthropathy of the knee is common among patients with hemophilia and is a major cause of severe joint pain and functional disability requiring total knee arthroplasty (TKA). We evaluated TKA outcomes and complications with a special focus on prosthetic survival and infection. We retrospectively reviewed the medical records of 74 patients with chronic hemophilic arthropathy of the knee treated with TKA (N = 88) over a 13-year period. The same type of implant was used in all cases. Fourteen patients had 2-stage bilateral TKAs. Mean patient age was 38.2 years (range, 24-73 years). Fourteen patients were positive for human immunodeficiency virus, and 32 for hepatitis C virus. Mean follow-up was 8 years (range, 1-13 years). The prosthetic survival rate with implant removal for any reason regarded as final endpoint was 92%. Causes of TKA failure were prosthetic joint infection (6.8%) and aseptic loosening (2.2%). Clinical outcomes of the primary TKAs in this series were good prosthetic survival and excellent pain relief. TKA infection continues to be a major concern for patients with hemophilia relative to patients without hemophilia.