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  Global Journal of Surgery. Volume 1, Issue 2 (2010) pp. 109-121
  Review Article
Total knee arthroplasty in hemophilia
  E. Carlos Rodriguez-Merchan  
Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain
  After reviewing the literature and my own experience, the results suggest that knee arthroplasty can relieve pain and improve function in symptomatic hemophilic patients. Knee arthroplasty is technically demanding due to soft tissue fibrosis, contractures and poor bone quality, and some complications can occur. Further studies are required to evaluate the long-term outcome of total knee arthroplasty in these patients including infection rates in HIV-positive patients and cost-benefit analyses in view of the considerable expenditure involved. It is important therefore for the patient to have realistic expectations of what surgery can offer and the importance of an experienced multidisciplinary team in the management of the hemophilic patient is paramount. Despite improvements in medical treatment, arthropathy remains a problem for many patients. Quality of life and immunological status are paramount in indicating whether a TKA is indicated in a hemophilic patient. Moreover, prior to joint replacement the potential risks and benefits must be considered.
  Hemophilia; Knee; Total arthroplasty; Outcome of TKA  

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