Copyright
©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Orthop. Oct 18, 2017; 8(10): 777-784
Published online Oct 18, 2017. doi: 10.5312/wjo.v8.i10.777
Published online Oct 18, 2017. doi: 10.5312/wjo.v8.i10.777
Total joint replacement in inhibitor-positive haemophilia: Long-term outcome analysis in fifteen patients
Heidi Danielson, Pekka Ylinen, Timo Yrjönen, Orton Orthopaedic Hospital, Invalid Foundation, Helsinki 00280, Finland
Riitta Lassila, Helsinki University and Coagulation Disorders unit, Department of Haematology and Comprehensive Cancer Centre, Helsinki University Hospital, Helsinki 00029, Finland
Author contributions: All the authors collecting and analyzing retrospective data, writing the article.
Institutional review board statement: This study has the approval of Helsinki University Hospital, Ethics Committee for Medical Study.
Informed consent statement: Patients involded have given their informed consent as required by the Helsinki University Hospital, Ethics Committee for Medical Study.
Conflict-of-interest statement: The authors stated that they had no competing interests, which might be perceived as posing a conflict or bias.
Data sharing statement: The data is in SPSS 20.0 form and is available from the corresponding author.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Timo Yrjönen, MD, PhD, Orton Orthopaedic Hospital, Invalid Foundation, Tenholantie 10, Helsinki 00280, Finland. timo.yrjonen@orton.fi
Telephone: +358-9-47481 Fax: +358-9-2418224
Received: March 10, 2017
Peer-review started: March 17, 2017
First decision: July 11, 2017
Revised: July 28, 2017
Accepted: August 15, 2017
Article in press: August 16, 2017
Published online: October 18, 2017
Peer-review started: March 17, 2017
First decision: July 11, 2017
Revised: July 28, 2017
Accepted: August 15, 2017
Article in press: August 16, 2017
Published online: October 18, 2017
Core Tip
Core tip: There are only few reports including joint arthroplasties on inhibitor-positive haemophilia patients. Generally the focus is mainly on immediate haemostatic outcome leaving the long-term orthopaedic results unreported. Our study brings out the importance of long-term and overall outcome when performing elective life-quality surgery. Management of inhibitor patients is especially challenging regarding not only the operative treatment but also the costs. As the health economic analysis of the topic is lacking, we provide new data. According to our cost analysis, preoperative immune-tolerance induction for high responder patients will bring cost- and outcome benefit both in surgery and preventing postoperative bleeds.