Bilateral total knee replacement for hemophilic arthropathy: a case report

Area of Science:

• Orthopedic Surgery
• Hematology
• Medical Case Study

Background:

• Von Willebrand disease (vWD) and hemophilia pose significant bleeding risks in orthopedic surgery.
• Joint bleeding is common in hemophilia but less understood in vWD, impacting daily life and arthropathy development.

Purpose of the Study:

• To present a case of bilateral total knee replacement (TKR) in a young female patient with Von Willebrand disease Type 3.
• To highlight the management of severe knee arthropathy and associated deformities in a patient with a bleeding disorder.

Main Methods:

• A 25-year-old female with vWD Type 3 and end-stage knee osteoarthritis underwent sequential bilateral TKR.
• Patient-specific templating (PST) technology was utilized for preoperative planning and surgical execution.
• The patient had a history of multiple prior knee surgeries, significant deformities, and osteopenia.

Main Results:

• Successful bilateral TKR was achieved with significant improvements in pain and mobility.
• The patient reported high overall satisfaction with no complications at the two-year follow-up.
• The sequential TKR approach was necessitated by financial and resource limitations.

Conclusions:

• Individualized treatment, meticulous surgical planning, and comprehensive postoperative care are crucial for managing knee arthropathy in patients with bleeding disorders.
• This case demonstrates the feasibility and positive outcomes of TKR in complex vWD patients.
• Patient-specific templating (PST) technology can aid in managing complex orthopedic cases in patients with bleeding disorders.