Mid-to Long-Term Survival of Total Knee Arthroplasty in Hemophilic Arthropathy

Abstract

While satisfactory results have been reported during short-to mid-term follow-up assessments of hemophilic patients who have undergone total knee arthroplasty (TKA), limited literature focusing on long-term survival following TKA exists to date. As part of this investigation, a consecutive series of 78 TKAs in 56 patients with hemophilic arthropathy was reviewed. The mean patient age at the time of operation was 38.7 years old and the mean length of follow up was 10.2 years. Clinical and radiologic outcomes, quality of life, complications, and long-term survivorship of TKA were evaluated. At the latest point of follow up, the average American Knee Society (AKS) knee and function scores had improved from 32.1 to 85.7 points and 41.5 to 83.3 points, respectively. Moreover, the average range of motion (ROM) was significantly increased from 64.2° preoperatively to 84.2° postoperatively. The physical and mental Short Form-36 results were also significantly improved at the latest point of follow up. Postoperative complications appeared in 12 knees (15.4%). The readmission rate in the 30 days after discharge was 6.4%. Revision TKA was performed in three knees for periprosthetic joint infection (n = 2 knees) and tibial component loosening (n = 1 knee). The Kaplan–Meier 10- and 13-year prosthesis survival rates were 97.1% and 93.2%, respectively. The current study suggests that the mid-to long-term results of TKA in patients with hemophilic arthropathy are favorable, with successful long-term prosthesis survival achievable in most cases.

Complications and Implant Survival of Total Knee Arthroplasty in People with Hemophilia

“…In 2020, Bae et al analyzed a series of 78 TKAs in 56 PWH [ 27 ]. The mean age was 38.7 years old and the mean follow up was 10.2 years.…”

“…Revision TKA was carried out in 3 knees for PJI and in 1 knee for loosening of the tibial component loosening. The prosthesis survival rates at 10 years and 13 years were 97.1% and 93.2%, respectively [ 27 ].…”

Estudo De Caso Clínico Diabetes Mellitus

“…Esses pacientes esperam ter maior nível de atividade física após a cirurgia, por isso, haverá maior demanda na articulação substituída e em consequência haverá maior desgaste dos seus componentes (KOTELA et al, 2017). Segundo Mortazavi et al (2020) a maior taxa de APA após ATJ em pacientes com AH grave pode ser atribuída à idade mais jovem no momento da primeira ATJ, que é em média 39 anos, e, portanto, ocorre uma maior demanda da endoprótese e mais desgaste (MERCHAN, 2015;BAE et al, 2020). A vida útil da endoprótese variou nos estudos analisados entre 5 e 20 anos.…”

A Cetamina Na Prevenção Da Dor Pósoperatória: Uma Revisão Sistemática Da Literatura

“…De acordo com Guild et al (2015), as IPA são compostas por um coquetel preparado adicionando-se 266 mg/20 ml de Exparel ® , 20 ml de bupivacaína 0,25%, 20 ml de soro fi siológico 0,9% e epinefrina 1:200.000 em uma seringa de 60 ml, sendo injetadas de 2 a 3 ml em oito regiões do joelho com inervação sensorial mais abundante, conforme demonstrado duas dessas regiões na fi gura 4. Já Bae et al (2020)…”