Joint distraction in advanced haemophilic ankle arthropathy

Rodríguez-Merchán, E. Carlos

doi:10.1111/hae.12884

Cited by 5 publications

(6 citation statements)

References 10 publications

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“…We achieved a transfusion rate of zero, which was noted previously in our setting [5, 8, 9], as in other studies [2, 3, 6, 12, 15, 16, 18, 19], in patients without hemophilia. Our results in patients with hemophilia are in agreement with the literature on patients without hemophilia, highlighting the potent effects of TXA in reducing blood loss [2–4, 6, 10, 12, 14, 17–19]. Our preliminary data in cases of hemophilia B and revision TKA in patients with hemophilia show similar results (data pending publication).…”

Section: Discussionsupporting

confidence: 90%

“…In a preliminary retrospective comparative study published as a letter to the editor in 2016, we found that the use of the MBLPM-TXA in primary TKA decreased the rate of post-operative blood transfusion in ten patients with hemophilia [10]. To try to confirm these findings, we designed a similar study of a larger number of cases.…”

Section: Introductionmentioning

confidence: 99%

“…However, the risks associated with allogeneic blood transfusion are well established [7]. Many authors have reported the efficacy and safety of intravenous [4, 5, 8, 9, 14, 16, 17] and intra-articular [2, 3, 6, 10–12, 15, 18, 19] tranexamic acid (TXA) in preventing blood loss during TKA.…”

Section: Introductionmentioning

confidence: 99%

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Intra-articular Tranexamic Acid in Primary Total Knee Arthroplasty Decreases the Rate of Post-operative Blood Transfusions in People with Hemophilia: A Retrospective Case-Control Study

Rodríguez-Merchán

Encinas-Ullán

Gómez-Cardero

2020

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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Background: Blood transfusion rates after total knee arthroplasty (TKA) in patients without hemophilia have diminished with the use of a standardized multimodal blood loss prevention method (MBLPM) that includes intraarticular tranexamic acid (TXA) (MBLPM-TXA). However, the topic has not been addressed in people with hemophilia. Questions/Purposes: Our aim was to investigate whether the MBLPM-TXA prevents blood loss in patients with hemophilia A who undergo TKA, thereby decreasing the need for post-operative blood transfusion. Methods: This retrospective case-control comparative study involved 30 TKA patients who had a severe degree of hemophilia A without inhibitions: one group treated with the MBLPM-TXA (n = 15) and a second group treated without it (n = 15). In all cases, the pre-operative hemoglobin level was greater than 13 g/dL. Results: The MBLPM-TXA group had a transfusion rate of zero, whereas 46.6% of the patients (seven of 15) in the non-MBLPM-TXA group needed transfusion. Conclusion: This retrospective case-control study showed that the use of an MBLPM-TXA in patients with hemophilia A who underwent TKA was effective in reducing rates of transfusion. We recommend its use.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

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Intra-articular Tranexamic Acid in Primary Total Knee Arthroplasty Decreases the Rate of Post-operative Blood Transfusions in People with Hemophilia: A Retrospective Case-Control Study

Rodríguez-Merchán

Encinas-Ullán

Gómez-Cardero

2020

HSS Journal®: The Musculoskeletal Journal of Hospital for Speci

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“…In addition to the VERITAS‐Pro score, adherence was assessed according to the consensus definition reported by Schrijvers et al. 8 Normally, the three components of this definition (ie missed infusions, dose changes and changes in timing of infusions) are assessed in person during a clinic visit. In this case, this was done by selecting and separately analysing three VERITAS‐Pro questions.…”

Section: Methodsmentioning

confidence: 99%

“… 6 , 7 For example, adherence was determined by evaluating infusion logs, using the adherence definition described by Schrijvers et al. 8 or performing short interviews. Most studies have been performed with limited datasets, varying from 31 7 to 78 5 patients.…”

Section: Introductionmentioning

confidence: 99%

Adherence to prophylaxis and its association with activation of self‐management and treatment satisfaction

et al. 2021

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Introduction Prophylactic replacement therapy (prophylaxis) in patients with haemophilia (PWH) requires lifelong, frequent (self)infusions. Prophylaxis effectiveness depends on adherence, and the drivers of treatment adherence among PWH are unclear. Aim To quantify prophylaxis adherence and associations between adherence and patients’ treatment attitudes and satisfaction in a large cohort of children and adults with haemophilia. Methods In a nationwide, cross‐sectional, questionnaire‐based study, PWH with complete information currently using prophylaxis were selected. Validated Hemophilia Regimen Treatment Adherence Scale‐Prophylaxis (VERITAS‐Pro; normalised score range: 0–100, optimum 0) measured treatment adherence; the Patient Activation Measure (PAM‐13; total score range 0–100, optimum 100) measured activation of self‐management; Hemophilia Patient Satisfaction Scale (Hemo‐Sat; range 0–100, optimum 0) measured treatment satisfaction. Groups were compared according to age (children: <12 years; adolescents: 12–18 years; adults >18 years) and adherence levels using non‐parametric tests, and correlations were assessed using Spearman's rho. Results Among 321 participants (median age 33 years, interquartile range [IQR]:15–54 years), adherence was high (median VERITAS‐Pro total score 17, 89% adherent) but worsened with age, with median scores of 5, 14 and 20 in children, adolescents, adults, respectively (p < .001). Attitudes towards treatment (median 66 vs. 68) participants and treatment satisfaction (12 vs. 10) were similar between adherent and non‐adherent patients. The VERITAS‐Pro total score was moderately correlated with PAM‐13 (r = .41) but not with Hemo‐Sat (r = −.11). Discussion Prophylaxis adherence was high (89%) but decreased significantly with age and was not correlated with treatment attitude or treatment satisfaction.

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Orthopedic surgical procedures in people with hemophilia

Encinas-Ullán¹,

Corte‐Rodríguez²,

Gómez-Cardero³

et al. 2023

Blood Coagulation &Amp; Fibrinolysis

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People with hemophilia tend to develop joint lesions secondary to the recurrent hemarthroses typical of their condition. These usually include chronic synovitis and arthropathy chiefly affecting their ankles, knees, and elbows. In addition, muscular hematomas, albeit less frequently, may also result in complications such as acute compartment syndrome, pseudotumors, bone cysts and peripheral nerve compression. Joint lesions may require some of the following surgical interventions: arthroscopic synovectomy (in cases of synovitis), arthroscopic joint debridement, radial head resection, opening-wedge tibial osteotomy, arthrodesis, arthrodiastasis (of the ankle), tendon lengthening (hamstrings, Achilles tendon), progressive extension of the knee by placing an external fixator in cases of flexion contracture of the knee, supracondylar femoral extension osteotomy in cases of knee flexion contracture and, eventually, a total joint arthroplasty when the affected joint has been destroyed and the patient experiences severe joint pain. Total knee arthroplasty in hemophilic patients is associated with a high infection risk (7% on average). As regards the complications following muscle hematomas, acute compartment syndrome requires urgent performance of a fasciotomy when hematological treatment is incapable of resolving the problem. Surgical resection of hemophilic pseudotumors is the best solution, with those affecting the pelvis (secondary to iliopsoas hematomas) being particularly difficult to resolve. Peripheral nerve lesions can often be effectively addressed with hematological treatment, although a surgical neurolysis of the ulnar nerve is indicated if nonoperative treatment fails.

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Joint distraction in advanced haemophilic ankle arthropathy

Cited by 5 publications

References 10 publications

Intra-articular Tranexamic Acid in Primary Total Knee Arthroplasty Decreases the Rate of Post-operative Blood Transfusions in People with Hemophilia: A Retrospective Case-Control Study

Intra-articular Tranexamic Acid in Primary Total Knee Arthroplasty Decreases the Rate of Post-operative Blood Transfusions in People with Hemophilia: A Retrospective Case-Control Study

Adherence to prophylaxis and its association with activation of self‐management and treatment satisfaction

Orthopedic surgical procedures in people with hemophilia

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