Orthopaedic surgery in hemophilic patients.

Since 1970 we performed 18 operations in hemophilic patients: 7 synovectomies, 2 elongations of the achilles-tendon, 1 hip arthrodesis, 2 endoprosthetic replacements of the hip, 2 intertrochanteric flexion- and varus-osteotomies, 1 excision of a pseudo-tumor and 2 removals of hematomas of the knee joint. The synovectomies were done only in joints affected by frequent hemorrhages. The bleeding frequency could be reduced considerably and the range of motion could be improved. The indication for several other orthopaedic procedures depended on the orthopaedic symptoms. The results were satisfactory without major complications during the healing period. During surgery and the following postoperative care the antihemophilic factor was substituted up to levels between 60 and 120%. The factor VIII or IX was controlled daily and Hb, GOT, GPT and the Australia antigen-antibody on a weekly base. The length of the substitution regimen was dependent on the individual wound healing and the postoperative treatment.