Yin DL, Lin JM, Li YH, Chen P, Zeng MD. Short-term outcome of total knee replacement in a patient with hemophilia: A case report and review of literature. World J Clin Cases 2023; 11(12): 2788-2795 [PMID: 37214564 DOI: 10.12998/wjcc.v11.i12.2788]
Corresponding Author of This Article
Mian-Dong Zeng, Doctor, Chief Doctor, Chief Physician, Department of Orthopedic, The Third Affiliated Hospital of Guangzhou Medical University, No. 63 Duobao Road, Guangzhou 510150, Guangdong Province, China. 13527611112@139.com
Research Domain of This Article
Orthopedics
Article-Type of This Article
Case Report
Open-Access Policy of This Article
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/
De-Long Yin, Yuan-Hui Li, Peng Chen, Mian-Dong Zeng, Department of Orthopedic, The Third Affiliated Hospital of Guangzhou Medical University, Guangzhou 510150, Guangdong Province, China
Jia-Min Lin, Department of Orthopedic, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, Hubei Province, China
Peng Chen, Department of Orthopedic, Yichang Chinese Medicine Hospital, Yichang 443003, Hubei Province, China
Author contributions: Yin DL and Zeng MD analyzed and interpreted the patient data; Lin JM assistance make plan for supplementation of clotting factors; Chen P performed the following up and collected the image data; Yin DL and Lin JM were a major contributor in writing the manuscript; Zeng MD, Li YH and Yin DL participated in the operation; all authors have read and approve the final manuscript.
Informed consent statement: Obtaining informed consent from the patient and all the data were collected and analyzed anonymously.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mian-Dong Zeng, Doctor, Chief Doctor, Chief Physician, Department of Orthopedic, The Third Affiliated Hospital of Guangzhou Medical University, No. 63 Duobao Road, Guangzhou 510150, Guangdong Province, China. 13527611112@139.com
Received: January 10, 2023 Peer-review started: January 10, 2023 First decision: January 30, 2023 Revised: February 15, 2023 Accepted: March 29, 2023 Article in press: March 29, 2023 Published online: April 26, 2023 Processing time: 105 Days and 21.1 Hours
Abstract
BACKGROUND
Hemophilia A is a rare inherited bleeding disorder caused by mutations in the factor VIII gene. This clotting factor plays an intrinsic role in the blood coagulation pathway. Patients with hemophilia may develop orthopedic manifestations such as hemarthrosis, but multiple malunion of fractures over the knee is rare and difficult to treat.
CASE SUMMARY
We report a patient with hemophilia A who developed severe knee osteoarthritis along with fracture malunion and nonunion. Total knee replacement was performed using a custom-made modular hinged knee prosthesis (cemented) equipped with extended distal and proximal stems. At 3 years’ follow-up, the patient exhibited excellent clinical function and remained satisfied with the surgical outcome. Surgical intervention was accompanied by rigorous coagulation factor replacement.
CONCLUSION
This case highlights various unique scenarios specific to individuals with hemophilia and fracture deformity.
Core Tip: This patient had hemophilia for many years, with hematopathic arthritis of both knees. An old fracture of the left lower extremity had healed, a distal femur fracture had recurred, and he had malunion of fractures of the proximal tibia and fibula. We resolved the left knee hematopathic arthritis, distal femur fracture nonunion, and proximal tibia fracture malunion with a single operation of total knee replacement with custom prosthesis.
