Safety and efficacy of three arthroscopic procedures using Holmium: Yag laser in two high‐responder haemophiliacs

Ménart,; Lalain,; Lienhart,; Déchavanne,; Négrier,

doi:10.1046/j.1365-2516.1999.00299.x

Cited by 16 publications

(15 citation statements)

References 13 publications

(10 reference statements)

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“…It is an easy procedure with a number of satisfactory results. With 198 Au synoviorthesis there is an expected 75% success rate, while with 90 Y and rifampicin synoviortheses there is an expected 85% or more success rate [13,19]. It is important to emphasize that no more than three synoviortheses can be repeated with a 3‐month interval.…”

Section: Discussionmentioning

confidence: 99%

“…Menart et al . [19] have recently reported on the efficacy and safety of three arthroscopic procedures using the Holmium : Yag laser in two high‐responder haemophiliacs. Such a procedure would appear to be superior to conventional arthroscopic synovectomy, which utilizes mechanical devices in haemophiliacs, because the laser might improve the quality of local haemostasis and the rapidity of postoperative recovery.…”

Section: Surgical Synovectomymentioning

confidence: 99%

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Methods to treat chronic haemophilic synovitis

Rodríguez-Merchán

2001

Haemophilia

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The aim of both synoviorthesis and surgical synovectomy is to remove the inflamed and hypervascular synovium as soon as possible in order to prevent the onset of haemophilic arthropathy. Ideally, however, these methods should be performed before the articular cartilage has eroded. Radioactive synoviorthesis is a relatively simple, virtually painless and inexpensive technique for the treatment of chronic haemophilic synovitis, even in patients with inhibitors. Thus, radioactive synoviorthesis is the best choice for patients with persistent synovitis. Personal experience and the general recommendation among orthopaedic surgeons and haematologists is that when three early consecutive synoviorthesis (repeated every 3 months) fail to halt synovitis, a surgical synovectomy (open or by arthroscopy) should be immediately considered.

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Section: Discussionmentioning

confidence: 99%

Section: Surgical Synovectomymentioning

confidence: 99%

Methods to treat chronic haemophilic synovitis

Rodríguez-Merchán

2001

Haemophilia

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“…The tranexamic acid dose was 2 g day −1 starting a day before the procedure. There were no thromboembolic complications reported and the patient was discharged after 9 days .…”

Section: Concomitant Treatment During Surgical Proceduresmentioning

confidence: 95%

Should anti‐inhibitor coagulant complex and tranexamic acid be used concomitantly?

Valentino

Holme

2015

Haemophilia

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Inhibitor development in haemophilia patients is challenging especially when undergoing surgical procedures. The development of an inhibitor precludes using factor VIII (FVIII) therapy thereby requiring a bypassing agent (BPA) for surgical bleeding prophylaxis if the FVIII inhibitor titre >5 BU. Concomitant use of anti-inhibitor coagulant complex (AICC) and tranexamic acid has been reported in the literature as a beneficial treatment for this population. Anti-inhibitor coagulant complex is known to cause an increase in thrombin generation and tranexamic acid inhibits fibrinolysis. Hence, the combined used of AICC and tranexamic acid has been limited due to safety concerns over possibilities of increased risk of thrombotic events and disseminated intravascular coagulation. However, the rationale for concomitant therapy is to obtain a potential synergistic effect and to increase clot stability. We conducted a literature review of past studies and individual case reports of concomitant use of AICC and tranexamic acid, which was extensively used during dental procedures. Evidence also exists for concomitant use of the combined therapy in orthopaedic procedures, control of gastrointestinal bleeding, epistaxis and cerebral haemorrhages. Some patients who received the combined therapy had failed monotherapy with a single BPA prior to combined therapy. There were no reports of thrombotic complications related to the concomitant therapy and haemostasis was achieved in all cases. Anti-inhibitor coagulant complex and tranexamic acid therapy was found to be safe, well-tolerated and effective therapy in haemophilia patients with inhibitors. Additional randomized controlled studies should be performed to confirm these findings.

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“…APCC has rarely been used to cover major elective orthopaedic surgical procedures. Only six elective knee surgeries have been performed using FEIBA ® (one knee arthroplasty, one knee synovectomy, three arthroscopic procedures and one bilateral knee arthroplasty) [20,21]. Excellent results were reported in five of these procedures, but excessive bleeding occurred in one knee arthroplasty and a cutaneomuscular plasty was required.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2001

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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. Rehabilitation was started on day 1 and continued for 3 months. Walking commenced on day 4. After 1 year of follow-up, the clinical outcome of surgery was considered excellent with no pain, knee mobility at 0-5-90 degrees, and an International Knee Society score of 95/100. No rFVIIa-associated side-effects or thrombotic complications were reported. In conclusion, knee joint arthroplasty is now an option for haemophilia patients with a high inhibitor titre. An international review of all available data on elective orthopaedic surgery in inhibitor patients is required so that the optimal treatment regime can be defined and the short- and long-term risk-benefit ratio of surgery compared to that of noninhibitor patients.

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Safety and efficacy of three arthroscopic procedures using Holmium: Yag laser in two high‐responder haemophiliacs

Cited by 16 publications

References 13 publications

Methods to treat chronic haemophilic synovitis

Methods to treat chronic haemophilic synovitis

Should anti‐inhibitor coagulant complex and tranexamic acid be used concomitantly?

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

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Safety and efficacy of three arthroscopic procedures using Holmium: Yag laser in two high‐responder haemophiliacs

Cited by 16 publications

References 13 publications

Methods to treat chronic haemophilic synovitis

Methods to treat chronic haemophilic synovitis

Should anti‐inhibitor coagulant complex and tranexamic acid be used concomitantly?

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

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Product

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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