Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
Department of Orthopaedics, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan.
J Int Med Res. 2023 Aug;51(8):3000605231195446. doi: 10.1177/03000605231195446.
Haemophilia A patients who develop factor VIII inhibitors pose a challenge with respect to bleeding and orthopaedic management. This is particularly relevant in cases requiring amputation. We present here a case of a patient with severe haemophilia A and inhibitors who had a history of multiple surgeries due to periprosthetic joint infection and a non-healing wound which led to above-knee amputation. Following the implementation of appropriate and suitable transfemoral prosthesis and emicizumab therapy, the patient experienced a significant improvement in mobility and quality of life without any adverse events or bleeding episodes. Additional studies are required to more fully understand treatment options for lower limb amputations in the haemophilia population.
患有因子 VIII 抑制剂的甲型血友病患者在出血和骨科管理方面面临挑战。这在需要截肢的情况下尤为相关。我们在此介绍一例患有严重甲型血友病和抑制剂的患者,该患者因假体周围关节感染和无法愈合的伤口多次接受手术,导致膝关节以上截肢。在实施了适当的经股假体和emicizumab 治疗后,患者的活动能力和生活质量有了显著改善,且没有发生任何不良事件或出血事件。需要进一步研究以更全面地了解血友病患者下肢截肢的治疗选择。