Knee Arthropathy and Bilateral Total Knee Arthroplasty Ratio in Hemophilia A Patients

Yıl 2019, Cilt: 9 Sayı: 3, 506 - 512, 16.09.2019

Levent Bayam , Justine Theaker Sanat V Shah

https://doi.org/10.31832/smj.573074

Cited By: 1

Öz

Objective:

This epidemiological
study was conducted in the
joint haematology-orthopaedics
clinic of a university hospital. The aim was to analyse the
data in terms of age and radiology of
patients with moderate
or severe haemophilia A and knee involvement.

 

Materials and Method:

This was a retrospective study
49 patients with knee problems out of 130 haemophilia A and
musculoskeletal problems.
Kellgren-Lawrence (KL) classification was used for
radiological assessments of osteoarthritis degree.

 

Results:

KL degree was 3 or 4 for most patients (27/39,
69.23%) in the group. There was statistically a meaningful correlation between
KL degree and patients’ age (Spearman’s: r_s
= 0.512, p = 0.001). There were 7 patients with KL degree
4 at the age of 50 or younger (14.29%).

 

25 patients in 49(51.02%)
had total knee arthroplasty(TKA) and 10(40%) of those was bilateral.  Mean age for bilateral
TKA(56.35) was
higher than unilateral(49.87).

 

There was a statistically meaningful
correlation between patient age and the patients with
TKA (Spearman’s: r_s
= 0.338, p = 0.017).
There were 2 revision surgeries out of 35 TKA (5.71%).
Most of the patients had prophylactic factor treatment (43,
87.75%).

 

Conclusion:

Our study signify the high ratio of bilateral
knee replacements in haemophilia A patients and how early age they progressed
to KL stage 4 comparing to normal population. These results show the importance
of patient care in this group of patients, close follow-up and prophylactic
treatment. They should be managed in experienced centres by an experience team
to decrease the risks and complications.

Anahtar Kelimeler

HemophiliaA, Total knee arthroplasty, Bilateral

Destekleyen Kurum

n/a

Proje Numarası

n/a

Teşekkür

n/a

Hemofili A Hastalarındaki Diz Artropatisi ve Bilateral Total Diz Artroplastisi Oranı

Öz

Amaç:

 

Hemofili hastalarında epidemiyolojik olarak
yapılan çalışmamızda, bir üniversite hastanesinin hematoloji-ortopedi ortak kayıtları
kullanıldı. Bu çalışmanın amacı, diz problemleri olan orta ve ağır hemofili
hastalarından elde edilen bilgileri, hastaların yaşı ve radyolojik açısından
degerlendirmekti. 

 

Gereç ve Yöntemler:

 

Retrospektif bir çalışma olup, iskelet-kas
sistemi problemleri olan 130 hemofili A hastasından diz problemli 49’u bu
çalısmaya dahil edildi. Kellgren-Lawrence(KL) sınıflaması, osteoartritlerin
radyolojik degerlendirmesinde kullanıldı. 
Elektronik datalardan elden edilen bilgiler, sonuçları analiz etmek ve
istatistiksel degerlendirmeler icin kullanıldı. 
 

 

Bulgular:

 

Düz diz grafiği çekilmiş hastaların
çoğunluğunda (27/39, %69,23), KL derecesi 3 veya 4 idi. KL derecesi ile
hastaların yaşları arasında istatistiksel olarak anlamlı bir korelasyon mevcut
idi (Spearman’s : r_s
= 0,512, p (2-tailed) = 0,001). Ayrıca, KL derecesi 4 olan 50 yas ve altında 7
hasta (%14,29) vardı. 

 

49 diz problemi olan
hastanın 25’inde (%51.02) total diz artroplasti (TDA)
yapıldı ve bunların da 10 tanesi (%40) bilateral idi. Bilateral TDA icin ortalama
yas (56.35), unilateral TDA dan
(49.87) daha yüksekdi.

 

Hastaların yaşı ile TDA
olmaları arasında istatistiksel olarak anlamlı bir korelasyon vardi (Spearman’s:
r_s
= 0,338, p = 0,017). 
35 TDA yapılan hastada 2 revizyon tesbit edildi (%5.71). çalışmaya
dahil edilen hastaların
çogu (43/49, %87.75), profilaktik
faktör tedavisi almaktaydı

 

 Sonuç:

 

Çalışmamız,
hemofili A hastalarındaki yüksek bilateral TDA oranını ve normal popülasyona
gore bu grubunun ne kadar erken yasta KL 4 safhasına ilerlediklerini
vurgulamaktadır. Bu sonuclar bize, bu grup hastalardaki
tedavi yaklaşımının, yakin takibin
ve profilaksinin önemini göstermektedir. Bu hastalardaki
risk ve komplikasyonları azaltmak icin, tedavileri, tecrübeli merkezlerde ve
özelleşmiş bir grup tarafından yapılmalıdır.    

Anahtar Kelimeler

Hemofili A, Total Diz Artroplastisi, Bilateral

Proje Numarası

n/a

Kaynakça

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