A Comparative Study On The Relationship Between Blood Loss And Therapeutic Effect After Knee Arthroplasty For Hemophiliac Arthritis And Osteoarthritis

Objective:To analyze the blood loss and HSS score after total knee arthroplasty in patients with hemophilia arthritis and osteoarthritis,and to explore the effectiveness and surgical effect of replacement therapy with coagulation factors in the perioperative period.Methods:A total of 15 male hemophilia A patients underwent total knee arthroplasty in the second hospital of shanxi medical university from March 2011 to June 2019,aged 22-46 years,with an average age of 31.5 ± 12.0 years.The patients were followed up for 18-30 months,with an average of 22.6 months.There were 16 male patients in the osteoarthritis group,aged 61-73 years,with an average age of(65.0±7.0)years.The patients were followed up for 15-26 months,with an average of 21.2 months.Total blood loss,dominant blood loss,recessive blood loss,decreased hemoglobin,operative time and postoperative wound healing were observed and recorded.Knee HSS score before and after surgery was recorded to evaluate the surgical efficacy.Results:The wound healing of the 31 patients was good,and no complications such as infection and prosthesis loosening occurred.Postoperative follow-up X-ray reexamination showed that the deformity was corrected preoperatively and the strength line recovered satisfactorily.There were no statistically significant differences in total blood loss,dominant blood loss,recessive blood loss and decreased hemoglobin between the two groups(P>0.05).The operation time was 132.50±30.00 minutes longer than 83.22±15.28 minutes for osteoarthritis(P<0.05).The total score,pain,function,muscle strength,flexion deformity and stability of the two groups were not statistically significant(P>0.05).The postoperative activity recovery of hemophilia patients was 10.6±3.5,lower than that of osteoarthritis patients 13.7±1.2(P<0.05).Compared with preoperative hemophilia patients,postoperative HSS scores were statistically significant(P< 0.05).Conclusion:Compared with patients with osteoarthritis,under the rational use of blood coagulation factor replacement therapy,through total knee replacement in treatment of hemophilia,arthritis,blood loss,surgical curative effect significantly,can significantly reduce the pain degree and improve quality of life,however,hemophilia patients had serious knee flexion contracture,postoperative recovery of knee joint mobility are not satisfied.