The impact of knee arthrodesis on gait kinematics, muscle activity and patient-reported outcome.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. 19. Expert Rev Hematol. 2022 Jan;15(1):65-82. doi: 10.1080/17474086.2022.2030218. Epub 2022 Jan 24. Total knee arthroplasty in hemophilia: lessons learned and projections of what's next for hemophilic knee joint health. Rodriguez-Merchan EC(1)(2), De la Corte-Rodriguez H(3), Alvarez-Roman T(4), Gomez-Cardero P(1), Encinas-Ullan CA(1), Jimenez-Yuste V(4). Author information: (1)Department of Orthopedic Surgery, La Paz University Hospital-IdiPaz, Madrid, Spain. (2)Osteoarticular Surgery Research, Hospital La Paz Institute for Health Research - IdiPAZ (La Paz University Hospital - Autonomous University of Madrid), Madrid, Spain. (3)Department of Physical and Rehabilitation Medicine, La Paz University Hospital-IdiPaz, Madrid, Spain. (4)Department of Hematology, La Paz University Hospital-IdiPaz, Madrid, Spain. INTRODUCTION: The purpose of this article has been to review the literature on total knee arthroplasty (TKA) in people with hemophilia (PWH), to mention the lessons we have learned from our own experience and to try to find out what the future of this type of surgery will be. AREAS COVERED: A Cochrane Library and PubMed (MEDLINE) search of studies related to TKA PWH was analyzed. In PWH, the complication rate after TKA can be up to 31.5%. These include infection (7.1%) and bleeding in the form of hematoma, hemarthrosis or popliteal artery injury (8.9%). In a meta-analysis the revision arthroplasty rate was 6.3%. One-stage or two-stage revision arthroplasty due to infection (septic loosening) is not always successful despite providing correct treatment (both hematological and surgical). In fact, the risk of prosthetic re-infection is about 10%. It is necessary to perform a re-revision arthroplasty, which is a high-risk and technically difficult surgery that can sometimes end in knee arthrodesis or above-the-knee amputation of the limb. EXPERT OPINION: TKA (both primary and revision) should be performed in centers specialized in orthopedic surgery and rehabilitation (knee) and hematology (hemophilia), and with optimal coordination between the medical team. DOI: 10.1080/17474086.2022.2030218