Department of Orthopedic Surgery, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Science, Beijing, China.
Division of Joint Osteopathy and Traumatology, Center of Orthopedics Surgery, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, School of Medicine, South China University of Technology, Guangzhou, China.
Haemophilia. 2020 Sep;26(5):861-866. doi: 10.1111/hae.14115. Epub 2020 Jul 27.
Patients with haemophilia are prone to haemophilic arthropathy (HA). For end-stage HA, total knee arthroplasty (TKA) is an effective procedure. However, limited data were available regarding complications of TKA in HA patients.
To provide comprehensive comparisons of TKA complications among patients with osteoarthritis (OA), rheumatoid arthritis (RA) or HA.
The present study was a single-surgeon cohort study including patients who underwent TKAs for OA, HA or RA from January 1997 to December 2017. The information of patients was extracted from medical records and follow-up database. The primary outcome was complications. Potential risk factors of complications in HA patients were also evaluated.
A total of 1515 patients with 2083 TKAs were selected following the criteria. The overall complication rate in the HA group was 21.79%, which was much higher than the OA or RA group (7.08% and 8.70%, respectively, P < .05). The dominate complications were prosthetic loosening and wound dehiscence. For HA, more complications occurred in the period more than 1 year after TKA when compared with OA (33.33% vs 11.43%, P = .028). Among the potential risk factors, patients with haemophilia B and severe haemophilia had significantly higher complication rates (P < .05 for both).
When compared with OA or RA, HA patients had different characteristics on complications, including the higher complication rate, different complication distribution and later occurring time. In HA patients who underwent TKA, haemophilia B and severe haemophilia were risk factors of complications which should be paid more attention to.
血友病患者易患血友病性关节炎（HA）。对于终末期 HA，全膝关节置换术（TKA）是一种有效的治疗方法。然而，关于 HA 患者 TKA 并发症的数据有限。
提供 OA、RA 或 HA 患者 TKA 并发症的综合比较。
本研究为单外科医生队列研究，纳入 1997 年 1 月至 2017 年 12 月期间接受 TKA 治疗的 OA、HA 或 RA 患者。患者信息从病历和随访数据库中提取。主要结局是并发症。还评估了 HA 患者并发症的潜在危险因素。
根据标准，共选择了 1515 例患者的 2083 例 TKA。HA 组的总体并发症发生率为 21.79%，明显高于 OA 或 RA 组（分别为 7.08%和 8.70%，P<.05）。主要并发症是假体松动和伤口裂开。与 OA 相比，HA 患者 TKA 后 1 年以上发生更多并发症（33.33% vs 11.43%，P=.028）。在潜在的危险因素中，血友病 B 和重度血友病患者的并发症发生率显著更高（两者均 P<.05）。
与 OA 或 RA 相比，HA 患者的并发症具有不同的特征，包括更高的并发症发生率、不同的并发症分布和更晚的发生时间。在接受 TKA 的 HA 患者中，血友病 B 和重度血友病是并发症的危险因素，应更加关注。
