Outcomes of Total Knee Arthroplasty in Patients with Bleeding Disorders

Advanced haemophilic arthropathy is a possible complication in patients with congenital bleeding disor-ders. This study aimed to assess treatment outcomes after primary total knee arthroplasty in this group of patients.

A total of 60 primary total knee arthroplasties were performed in the period 2011-2014. The study ultimately included 40 knee replacements in 35 patients. The average follow-up period was 19.4 months (max. 32, min. 12), with patients followed up for a period shorter than 12 months excluded from the study. The average age of the patients was 36.7 years (min. 27, max. 72). Types of inherited bleeding disor-ders among the study population were as fol-lows: 82% with haemophilia A, 15% with haemophilia B and 1% with Von Willebrand disease. Pain intensity was assessed before the surgery and at a 12-month follow-up visit using VAS. The patients completed the OKS and WOMAC question-naires before the surgery and at the 12-month follow-up visit. Functional evaluation of the patients was performed using KSS before the TKA and 12 months after the knee replacement surgery.

The pain intensity was considerably reduced 12 months after the surgery. VAS scores averaged 7.4 pts (SD 1.6) before TKA and 1.6 pts (SD 1.7) after the surgery. A significant improvement in patients' functioning was recorded. The average WOMAC score was 33 pts (SD 26) before the operation and 72.7 pts (SD 23.4) after TKA. Similar results were obtained for OKS: 20.9 pts (SD 7.3) before knee replacement and 41.2 pts (SD 2.4) after the surgery. The average KSS score before TKA was 29.2 pts (SD 22.8) and 71.5 pts (SD 9.5) after 12 months.

1. Total knee arthroplasty is a very good therapy for patients with advanced haemophilic arthropathy. 2. TKA considerably reduces pain intensity in patients. 3. TKA considerably improves patients' functioning in daily life. 4. Patients are very satisfied with the outcomes of this procedure.