Thadi Mohan, Mane Prajwal P, Sharma Anubhav
Department of Orthopaedics, Amrita Institute of Medical Sciences, Kochi, Kerala, India.
Department of Orthopaedics, Kasturba Medical College, Manipal, Udupi, Karnataka, India.
J Orthop. 2019 Nov 12;19:194-198. doi: 10.1016/j.jor.2019.11.011. eCollection 2020 May-Jun.
Haemophilia is characterized by a partial or complete deficiency of clotting factor VIII or IX. The repeated bleeding episodes into the joints contributes to subsequent chronic arthropathy which debilitates the patient and affects the quality of life. There are lot of hurdles in successful management of such patients. We present our experience in dealing such patients.
24 patients (27 knees) with haemophilic knee arthropathy were included. The preoperative VAS (Visual Analogue Scale) and KSS (Knee Society Score) were assessed. All underwent total knee arthroplasty with stemmed constrained prosthesis. Postoperatively VAS and KSS were analysed at the end of 12 months.
The mean preoperative VAS was 8.2 (Range: 7-10), mean KSS clinical score was 39.9 (Range: 12-61) and mean KSS functional score was 51.4(Range: 20-70). The mean postoperative VAS was 2.7(Range: 2-4), mean KSS clinical score was 70.5 (Range: 61-80) and mean KSS functional score was 74.2(Range: 60-80). There was statistical significant difference between preoperative and post-operative scores. At the end of 12 months, 17 patients (63%) had good outcome, seven patients (26%) had fair and three patients (11%) had excellent outcome as per the KSS scores.
Total knee arthroplasty has good outcome with respect to clinical as well as functional outcome in haemophilic arthropathy. Although the results and outcome of total knee arthroplasty in haemophilic knee arthropathy may still be inferior to the results seen in a normal individual, a multidisciplinary approach yields a better functional and quality of living in such haemophilic patients.
血友病的特征是凝血因子 VIII 或 IX 部分或完全缺乏。关节反复出血会导致随后的慢性关节病，使患者虚弱并影响生活质量。成功管理此类患者存在许多障碍。我们介绍我们处理此类患者的经验。
纳入 24 例（27 膝）血友病性膝关节炎患者。评估术前视觉模拟评分（VAS）和膝关节协会评分（KSS）。所有患者均接受带柄限制性假体全膝关节置换术。术后 12 个月时分析 VAS 和 KSS。
术前 VAS 平均为 8.2（范围：7 - 10），KSS 临床评分平均为 39.9（范围：12 - 61），KSS 功能评分平均为 51.4（范围：20 - 70）。术后 VAS 平均为 2.7（范围：2 - 4），KSS 临床评分平均为 70.5（范围：61 - 80），KSS 功能评分平均为 74.2（范围：60 - 80）。术前和术后评分之间存在统计学显著差异。根据 KSS 评分，12 个月时，17 例患者（63%）预后良好，7 例患者（26%）预后一般，3 例患者（1l%）预后优秀。
全膝关节置换术在血友病性关节病的临床和功能结局方面有良好效果。尽管血友病性膝关节炎全膝关节置换术的结果可能仍不如正常个体，但多学科方法能使此类血友病患者获得更好的功能和生活质量。
