Orthopaedic surgery in hemophilia. 20 Years' experience in Sweden.
Clin Orthop Relat Res. 1996 Nov;(332):232-41
T. Löfqvist
I M Nilsson
C. Petersson
Department of Orthopedics, University of Lund, University Hospital, Malmö, Sweden.
Elbow Joint - surgery
Factor IX - therapeutic use
Factor VIII - therapeutic use
Hemophilia A - drug therapy - surgery
Hip Prosthesis - statistics & numerical data
Knee Joint - surgery
Knee Prosthesis - statistics & numerical data
Orthopedics - statistics & numerical data - trends
Synovial Membrane - surgery
At the International Hemophilia Center, Malmö, Sweden, which serves a large proportion of the Swedish hemophilia population, 98 orthopaedic surgical procedures were performed from 1970 to 1989 in 66 patients ranging in age from 6 to 71 years. The most common procedures were knee synovectomy, elbow synovectomy in combination with resection of the radial head, and total hip replacement. Comparing the 2 decades of the period, 3 differences were observed: a decreasing need of surgery, an increasing average age of the patients, and a change in the kinds of operations performed. Knee synovectomy and achillotenotomy were most frequent during the 1970s, whereas elbow synovectomy with resection of the radial head and total hip replacement were most frequent during the 1980s. Owing to the availability of regular factor replacement therapy as practiced at the Malmö Center, the situation of patients with hemophilia has improved dramatically during the last 2 decades. In the authors' opinion, it is now possible to avoid hemophilic arthropathy almost completely by giving effective continuous prophylaxis from an early age. In all likelihood, this is the explanation of the changing picture of orthopaedic surgery in patients with hemophilia today.
8913168 View in PubMed