Special Features of Total Knee Replacement in Hemophilia

Emerito Carlos Rodriguez-Merchan

Expert Rev Hematol. 2013;6(6):637-642.

General Anesthesia

In hemophilia patients, it is very risky to perform spinal anesthesia, since a hemorrhage in this zone could cause irreversible neurological damage. For this reason, although general anesthesia leads to greater risk than the spinal alternative, in cases of hemophilia, it is always preferable to use general anesthesia.^[13]

1 2 3 4 5 6 7 8 9 10 11 12 13 14

Next Section

Table 1. Prosthetic lifespan in hemophiliac patients (percentage of primary total knee replacement removal-free survival).
Study (year)	Percentage of TKR removal-free survival	Ref.
Solimeno et al. (2009)	81 at 7 years	[20]
Cohen et al. (2000)	88.4 at 10 years	[21]
Sikkema et al. (2011)	94 at 20 years	[22]

TKR: Total knee replacement.

Box 1. Risk factors of infection following total knee replacement in general population.
Patient-related risk factors (immunosuppression treatment and previous infections in the knee) Lack of systematic preoperative screening by swab (nose and any skin lesion(s) during the month preceding surgery, recent history of surgery) Inadequate preoperative antibiotic prophylaxis Inappropriate surgeon's preparation and unclean air in the operating room. Inadequate skin preparation and dressings Intravenous therapy