Arthroplasty Today (Mar 2020)

Total knee arthroplasty in hemophilia A

  • Neil Pathak, BS,
  • Alana M. Munger, MD,
  • Ahmad Charifa, MD,
  • William B. Laskin, MD,
  • Emily Bisson, APRN, CPNP,
  • Gary M. Kupfer, MD,
  • Lee E. Rubin, MD

Journal volume & issue
Vol. 6, no. 1
pp. 52 – 58.e1

Abstract

Read online

Hemophilia A is a rare genetic disorder involving a deficiency of clotting factor VIII. Coagulation factor replacement therapy has prolonged the life expectancy of patients with hemophilia, but recurrent hemarthrosis of major joints is often a common occurrence. Therefore, orthopaedic adult reconstructive surgeons increasingly encounter hemophilic arthropathy in young adults and consider treating with total joint arthroplasty. In this report, the authors describe a patient with hemophilia A and severe knee osteoarthritis, who was subsequently treated with primary total knee arthroplasty. This rare case is an opportunity to explore a variety of unique clinical scenarios specific to patients with hemophilia, including the maintenance of optimal factor VIII levels through clotting factor infusions and prevention of a venous thromboembolic event. Keywords: Hemophilia A, Total knee arthroplasty, Factor VIII, Hemophilic arthropathy