Les prothèses totales de genou dans l'arthropathie hémophilique

Seventy‐two total knee arthroplasties performed in patients with haemophilia using continuous infusion

“…Haematomas and haemarthroses are common complications of TKR but experiences reported by different centres are variable [3, 6, 23, 24]. A recent review reported 17 bleeding complications (5·35%) in 318 patients who had elective surgeries (major and minor) and treated by continuous infusion [23], whilst another study reported three haemarthroses (27·3%) from a series of 11 TKR [24].…”

“…Total knee replacement (TKR) is the treatment of choice in case of end‐stage haemophilic knee arthropathy [2]. TKR results in pain relief, functional improvement and better quality of life [3, 4]. Several studies reported favourable results of TKR [5], although a number of postoperative complications were frequently reported such as bleeding, infection and stiffness [6].…”

Total knee arthroplasty in severe haemophilic patients under continuous infusion of clotting factors

“…Only 2 studies have used a continuous infusion protocol [23, 36]. The protocol used by Legroux‐Gerot [23] was kept for an average 3 days and followed by intermittent infusions, which could explain the 5 early post‐operative haematomas reported, with 4 knees requiring surgical revision. One patient developed extensive skin necrosis after the revision.…”

“…Improvement in ROM is commonly reported by authors but with variable results [2, 6, 11, 13, 19, 20, 22, 23, 26]. Chiang et al [6] observed a mean post‐operative ROM of 79.8° with a 16.6° gain compared to Thomason et al [41] who report a ROM inferior to 45° in 7 cases out of 23, with a flexion contracture over 10° in 10 cases.…”

“…Few studies have evaluated the benefit of continuous infusion of clotting factors on the long‐term results [23, 36].…”