Carulli C, Zago M, Rizzo A R, Innocenti M
Orthopaedic Clinic, Department of Surgery and Translational Medicine University of Florence, Italy
J Biol Regul Homeost Agents. 2017;31(4 suppl 1):15-19.
Haemophilia is an inherited haemorrhagic disease characterized by the lack of coagulative factors associated nowadays mostly to musculoskeletal complications, particularly severe secondary arthritis in specific joints. Recurrent traumatic or spontaneous joint bleeding, induce severe arthropathy at a young age that can be treated only by joint replacement. Total knee or hip arthroplasty in young subjects may fail earlier due to wear or infections and in the haemophilic population, this means bone loss, pseudo tumours and the need of revision or even limb salvage surgery. Modern modular implants and the use of bone graft enriched by tissue engineering techniques such as a concentration of autologous mesenchymal cells or PRP may be helpful to compensate all bone loss and anatomic alterations due to failures of orthopaedic implants. The authors present their experience with this type of surgery and their biological approach to these challenging cases.
血友病是一种遗传性出血性疾病，其特征是缺乏凝血因子，目前主要与肌肉骨骼并发症相关，尤其是特定关节的严重继发性关节炎。反复的创伤性或自发性关节出血，在年轻时就会引发严重的关节病，而这种关节病只能通过关节置换来治疗。年轻患者的全膝关节或髋关节置换术可能会因磨损或感染而更早失败，在血友病患者群体中，这意味着骨质流失、假肿瘤以及需要翻修甚至保肢手术。现代模块化植入物以及使用通过组织工程技术富集的骨移植材料，如浓缩的自体间充质细胞或富血小板血浆（PRP），可能有助于弥补因骨科植入物失败导致的所有骨质流失和解剖结构改变。作者介绍了他们在这类手术方面的经验以及针对这些具有挑战性病例的生物学方法。
