Total Knee Replacement as Treatment for Hemophilic Arthropathy: A Case Series

Background and objectives Hemophilic arthropathy is a known complication of patients with hemophilia, with the knee as the commonest joint affected. Patients with this condition have severe pain and restricted joint mobility, affecting their activities of daily living. Total knee replacement can increase these patients' quality of life. Nevertheless, this surgery has a high risk of complications due to the nature of the underlying hemophilia. In this study, we present the short-term outcome of a case series of six patients with hemophilic arthropathy who underwent total knee replacement at a hospital with hematology support performed by an experienced arthroplasty surgeon. Patients and method This study reviewed and included eight consecutive total knee replacements in six patients with hemophilic arthropathy performed by a single board-certified arthroplasty surgeon from 2019 to 2023. The demographic profile of the patients, pre- and postoperative range of movement, and short-term outcome scores were summarized. Results The mean preoperative flexion contracture was 10.6° (range: 5°-30°), and it was 0.7° (range: 0°-5°) postoperatively. The mean preoperative flexion of the knee was 78.1° (range: 45°-110°) and 98.8° postoperatively. At six-month follow-up, the average Knee Society Score expectation, satisfaction, and functional scores had improved from 8.3 to 13.8 points, 20 to 38.5 points, and 42.8 to 80.5 points, respectively. Conclusion This study suggests that short-term results of total knee replacement in patients with hemophilic arthropathy are favorable, with increased range of movement and quality of life. We also conclude that surgery should be performed by an experienced surgeon with the support of a dedicated hematology unit.