2001
DOI: 10.1046/j.1365-2516.2001.00501.x
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Knee joint arthroplasty in a patient with haemophilia A and high inhibitor titre using recombinant factor VIIa (NovoSeven®): a new case report and review of the literature

Abstract: Elective orthopaedic surgery is regularly withheld from patients with haemophilia and high inhibitor titre despite the presence of severe arthropathy and urgent medical need. A knee joint arthroplasty was performed in a patient with severe haemophilia A and a high inhibitor titre using recombinant factor VIIa (rFVIIa) as the sole coagulation factor. There was no abnormal bleeding during surgery although an increased blood loss through surgical drains did occur during the first 6 h postoperatively. Rehabilitati… Show more

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Cited by 36 publications
(33 citation statements)
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“…A similar strategy combining immunoadsorption, substitution of FVIII and postoperative administration of FEIBA TM was used in our patient and also found to be effective and safe. In haemophilia patients with inhibitor, rFVIIa has been used for haemostasis for elective surgery [20] and also for total knee arthroplasty [21]. There are few cases of major elective surgery covered by APCCs [3,20].…”
Section: Discussionmentioning
confidence: 99%
“…A similar strategy combining immunoadsorption, substitution of FVIII and postoperative administration of FEIBA TM was used in our patient and also found to be effective and safe. In haemophilia patients with inhibitor, rFVIIa has been used for haemostasis for elective surgery [20] and also for total knee arthroplasty [21]. There are few cases of major elective surgery covered by APCCs [3,20].…”
Section: Discussionmentioning
confidence: 99%
“…The model default for the cost of arthropathy treatment has been derived from the Faradji et al. paper reporting the amount of rFVIIa used and hospitalization for high‐responding haemophilia A patients undergoing a knee joint arthroplasty [27]. The estimated cost per arthroplasty procedure is £414 120.…”
Section: Cost Assumptionsmentioning
confidence: 99%
“…Only English language literature was considered. Fifty articles were subsequently identified [10–57]. Underlying coagulopathy and/or the results of rFVIIa treatment in congenital haemophilia patients with inhibitors could be ascertained in only 46 of the 50 articles identified.…”
Section: Methodsmentioning
confidence: 99%