Complications and Implant Survival of Total Knee Arthroplasty in People with Hemophilia

Total knee arthroplasty (TKA) is a commonly used option in advanced stages of knee arthropathy in people with hemophilia (PWH). The objective of this article is to determine what the complication rates and implant survival rates in PWH are in the literature. A literature search was carried out in PubMed (MEDLINE), Cochrane Library, Web of Science, Embase and Google Scholar utilizing the keywords hemophilia TKA complications on 20 October 2022. It was found that the rate of complications after TKA in PWH is high (range 7% to 30%), although it has improved during the last two decades, possibly due to better perioperative hematologic treatment. However, prosthetic survival at 10 years has not changed substantially, being in the last 30 years approximately 80% to 90% taking as endpoint the revision for any reason. Survival at 20 years taking as endpoint the revision for any reason is 60%. It is possible that with a precise perioperative control of hemostasis in PWH, the percentage of complications after TKA can be diminished.

Automated summary

A literature search found that the rate of complications after TKA in people with hemophilia is high (ranging from 7% to 30%), although it has improved during the last two decades with better perioperative hematologic treatment. However, the prosthetic survival rate at 10 years has not substantially changed, remaining approximately 80% to 90% over the past 30 years. The survival rate at 20 years with revision as the endpoint is 60%. Precise perioperative control of hemostasis in people with hemophilia may reduce the percentage of complications after TKA.