Goddard N J, Mann H A, Lee C A
Department of Trauma and Orthopedics, The Royal Free Hospital, Pond Street, London NW3 2PS, UK.
J Bone Joint Surg Br. 2010 Aug;92(8):1085-9. doi: 10.1302/0301-620X.92B8.23922.
Haemophilia is an x-linked inherited bleeding disorder which can cause severe arthropathy. We have reviewed the results of 70 primary total knee replacements (TKR) performed in 57 haemophilic patients between 1983 and 2007. The functional results were assessed using the Hospital for Special Surgery (HSS) knee scoring system and Kaplan-Meier survivorship analysis. Six patients died. HSS scores were available for 60 TKRs at a mean follow-up of 9.2 years (2 to 23); 57 (95%) had good or excellent results. Deep infection was recorded in one patient. Kaplan-Meier analysis using infection and aseptic loosening as endpoints showed the survival rate at 20 years to be 94.0%. A reduction in infection, spontaneous haemarthrosis and improvement in the quality of life were noted to justify surgery in our series of patients with a mean age of 43 (25 to 70). We have found that using the latest techniques of continuous infusion of clotting Factor have significantly helped to reduce the complication rates and have achieved results which match those of the non-haemophilic population undergoing TKR.
血友病是一种X连锁遗传性出血性疾病，可导致严重的关节病。我们回顾了1983年至2007年间在57例血友病患者中进行的70例初次全膝关节置换术（TKR）的结果。使用特种外科医院（HSS）膝关节评分系统和Kaplan-Meier生存分析评估功能结果。6例患者死亡。60例TKR的HSS评分在平均随访9.2年（2至23年）时可用；57例（95%）结果良好或优秀。1例患者出现深部感染。以感染和无菌性松动为终点的Kaplan-Meier分析显示，20年生存率为94.0%。在我们平均年龄为43岁（25至70岁）的一系列患者中，感染、自发性关节积血减少以及生活质量改善，证明手术是合理的。我们发现，使用最新的凝血因子持续输注技术显著有助于降低并发症发生率，并取得了与接受TKR的非血友病人群相当的结果。
