A Retrospective, Long‐term Follow‐up of the Clinical Outcomes and Cost‐effectiveness of Single‐anesthetic Multiple Total Joint Procedures in Hemophilic Arthropathy

Abstract

Objective Although total joint replacement (TJR) procedures are efficacious, perioperative high‐dose factors replacement therapy (FRT) to avoid catastrophic bleeding represents a significant hurdle, particularly for patients with multiple joint affection. Double simultaneous bilateral TJRs were reported as safe and cost‐effective. However, little is known about multiple TJRs. The feasibility and effects remain debatable. Surgeons need to weigh the high cost of FRT against safety. Accordingly, we aimed to evaluate the clinical outcomes and cost‐effectiveness of single‐anesthetic multiple‐joint procedures of lower limbs in end‐stage hemophilic arthropathy. Methods Our retrospective cohort study retrieved data from an inpatient database of patients with hemophilia who underwent total knee arthroplasty (TKA), total hip arthroplasty (THA), and/or ankle arthrodesis from January 2000 to April 2016. Complications, hospital stays, transfusion, doses of clotting factor, medical costs, range of motion (ROM), Harris hip scores (HHSs) and Hospital for special surgery knee scores (HSSs) were recorded. A P value 0.05). Conclusion Our data indicated that simultaneous multiple TJRs are a safe and cost‐effective choice for treating hemophilic patients with multiple HA‐affected lower limb joints.

Keywords

• Complication
• Cost‐effectiveness
• Hemophilic arthropathy
• Simultaneous multiple total joint replacements