Meta‐analysis: outcomes of total knee arthroplasty in the haemophilia population

Moore, Monica; Tobase, P.; Allen, Diane D.

doi:10.1111/hae.12885

Cited by 55 publications

(72 citation statements)

References 49 publications

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“…In fact, at discharge they reached a good level of independence as shown by an improved health status and MRC score and a significant reduction in VAS and EQ‐5D‐3L scores, which is in line with the published literature . Indeed, a recent meta‐analysis of outcomes after TKR in PWH identified statistically significant clinical and functional improvement as well as improved ROM . As shown here, ROM recovery after TJR rehabilitation was successful; patients improved their mobility and had a significant gain of function at discharge.…”

Section: Discussionsupporting

confidence: 90%

“…31 Indeed, a recent meta-analysis of outcomes after TKR in PWH identified statistically significant clinical and functional improvement as well as improved ROM. 32 As shown here, ROM recovery after TJR rehabilitation was successful; patients improved their mobility and had a significant gain of function at discharge. ROM improved markedly not only towards flexion (by approximately +40° and +30° compared with presurgery values in knee and hip flexion, respectively), but even in overall pROM that averaged approximately 50° more than presurgery for TKR, 30° for THR and 10° for TAR.…”

Section: Discussionsupporting

confidence: 62%

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Standard and water rehabilitation: An analysis of over 14 years' experience in patients with haemophilia or other clotting factor disorders after orthopaedic surgery

Passeri¹,

Martinelli²,

Gatteri³

et al. 2019

Haemophilia

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Introduction In people with haemophilia (PWH) with severe arthropathy, total joint replacement (TJR) can be undertaken if conservative management fails. Post‐operative rehabilitation treatment is an important part of the comprehensive management of patients undergoing TJR. Aim To compare post‐operative standard rehabilitation (SR) and SR plus water rehabilitation (WR) in PWH undergoing TJR. Methods PWH who were admitted to our centre between June 2003 and December 2016 for rehabilitation after TJR were included in the study. Rehabilitation included SR (ie, manual and mechanical mobilization, scar tissue massage, light muscle strengthening exercises and walking training with and without crutches) with or without WR. WR exercises with floats of different size and volume were performed when possible. Range of motion (ROM), muscle strength, pain level, perceived health status and length of hospital stay were analysed retrospectively. Results A total of 184 patients (233 rehabilitation programmes were enrolled in the study, corresponding to 160 after total knee replacement [TKR], 37 after total ankle replacement [TAR] and 36 after total hip replacement [THR]). Fifty‐eight (25%) patients were treated with WR in addition to SR (32 for TKR, 19 for TAR and 7 for THR) with an average of 5.7 hours of WR. Muscle strength, pain and perceived health status improved significantly after rehabilitation. Conclusion This non‐randomized study seems to indicate that WR plus SR improves muscle strength, pain and perceived health status more than SR alone in PWH undergoing TJR. It would be necessary, however, to carry out randomized comparative studies to confirm these provisional conclusions.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 62%

Standard and water rehabilitation: An analysis of over 14 years' experience in patients with haemophilia or other clotting factor disorders after orthopaedic surgery

Passeri¹,

Martinelli²,

Gatteri³

et al. 2019

Haemophilia

View full text Add to dashboard Cite

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“…4 Reported infection rates are higher in patients with inherited bleeding disorders, 10%-16% vs 1%-2% in the general population potentially due to increased bleeding risks and pre-existing viral load. [5][6][7][8] Higher revision rates are observed in this group when compared to survivorship data for those without bleeding disorders (THR 95%; TKR 94% at 10 years, respectively). 9,10 Peri-operative considerations unique to this population must be addressed in order to optimize patient outcomes, further emphasising the need for these patients to be managed in a tertiary haemophilia centre with experienced practitioners providing patient-centred multidisciplinary care.…”

mentioning

confidence: 68%

“…A recent meta‐analysis (2016) evaluated the outcomes of TKR in patients with haemophilia (PWH) . Ten studies (N = 336 in 254 PWH) had sufficient data for meta‐analysis with a mean follow‐up of 6.3 years.…”

Section: Introductionmentioning

confidence: 99%

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Clinical outcomes and patient satisfaction following total hip and knee arthroplasty in patients with inherited bleeding disorders: A 20‐year single‐surgeon cohort

Anderson

Halliday

2018

Haemophilia

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Responsiveness of Subjective and Objective Measures of Pain and Function Following Operative Interventions for Musculoskeletal Conditions: A Narrative Review

Waddell,

Musbahi,

Collins

et al. 2024

Arthritis Care & Research

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Musculoskeletal (MSK) disorders affect ~50% of US adults and 75% of those over age 65, representing a sizeable economic and disability burden. Outcome measures, both objective and subjective, help clinicians and investigators determine whether interventions to treat MSK conditions are effective. This narrative review qualitatively compared the responsiveness of different types of outcome measures, a key measurement characteristic that assesses an outcome measure's ability to detect change in patient status. We evaluated elective orthopedic interventions as a model for assessing responsiveness because the great majority of patients improve following surgery. We searched for articles reporting responsiveness [quantified as effect size (ES)] of subjective and objective outcome measures after orthopedic surgery and included 16 articles reporting 17 interventions in this review. In 14 of 17 interventions, subjective function measures had an ES >10% greater than objective function. Two reported a difference in ES of <10%. The sole intervention that demonstrated higher ES of objective function used a composite measure. 16 interventions reported measures of subjective pain/mixed measures and subjective function. In nine interventions, subjective pain had higher ES than subjective function by >10%, in three subjective function had higher ES than subjective pain by >10%, and in the remaining four the difference between pain and function was <10%. These findings reinforce the clinical observation that subjective pain generally changes more than function following elective orthopedic surgery. They also suggest that subjective function measures are more responsive than objective function measures, and composite scores may be more responsive than individual performance tests.

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Meta‐analysis: outcomes of total knee arthroplasty in the haemophilia population

Abstract: TKA is an effective procedure for improving ROM and decreasing functional deficits resulting from haemophilic arthropathy. Knee score data shows TKA improves overall function. This study guides clinicians regarding outcome expectations post-TKA in PWH.

Cited by 55 publications

References 49 publications

Standard and water rehabilitation: An analysis of over 14 years' experience in patients with haemophilia or other clotting factor disorders after orthopaedic surgery

Standard and water rehabilitation: An analysis of over 14 years' experience in patients with haemophilia or other clotting factor disorders after orthopaedic surgery

Clinical outcomes and patient satisfaction following total hip and knee arthroplasty in patients with inherited bleeding disorders: A 20‐year single‐surgeon cohort

Responsiveness of Subjective and Objective Measures of Pain and Function Following Operative Interventions for Musculoskeletal Conditions: A Narrative Review

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