Total Knee Arthroplasty

Total Knee Arthroplasty is one of the most performed procedures in the haemophilic population. Several series have been released over the last decades: despite good clinical outcomes, high rates of complications such as infection and loosening have been reported. Such complications have been mainly related to coinfected patients (HIV-positive) and subjects with inhibitors frequently affected by uncontrolled bleedings. Moreover, almost all arthroplasties have been performed using standard cemented Cobalt-Chrome knee implants and generally high constraints to ensure the stability of the prostheses. Recently new biomaterials with a better tribology and implants with less constraints have been used in haemophiliacs with encouraging results. The present mean survivorship is more than 90% at a mid-term follow-up while it was about 82.5% (range: 68%-96%) in the period ’70-‘90s. Dedicated multidisciplinary teams, appropriate bleeding management, and modern modular implants may ensure even better outcomes than the last decades with rates of success and complications very close to those of the non-haemophilic population.

Keywords: Haemophilia, Knee arthropathy, Oxidized zirconium, Total knee arthroplasty, Tribology.