| Background: Haemophilia is an x-linked recessive hemorrhage caused by insufficient coagulation factors,with a high incidence,severe patients may have several bleeding a month,usually spontaneous bleeding due to minor trauma or activities of daily life.Approximately 90% of the bleeding in the patients occurred within the musculoskeletal system,with 80% occurring within the joint（mainly the elbow,knee and ankle joints）.End-stage knee arthritis,deformity and limited activity,seriously affect the quality of life,with the development of total knee replacement,total knee replacement can be used as a treatment for end of knee arthritis.Objective: To study the deformity and improvement of the quality of life after TKA and provide the basis for TKA in terminal knee arthritis.Methods: Collect and record the relevant clinical data of 15 patients（20 knees）with knee HA in February 2018 to February 2020（age,preoperative DR and full-length DR,pain,walking distance and time,up and down stairs,and measure the activity and stability of the target knee joint,etc.）.All 15 patients（20 knees）were diagnosed of hemophilia A,aged 22 – 55 years,and had a median age of 34 years.Results: After TKA for hemophilia knee arthritis,there were no complications including infection,deep vein thrombosis,aseptic prosthetic loosening,and periprosthetic fracture during follow-up,and HSS score and AKS score were above the2 years after surgery.The two-paired sample rank-sum test was used to compare the differences between the groups,draw a conclusion P<0.001,patient HSS score and AKS score were significant at 2 years after surgery.Prepreoperative HSS score 40.3 ±6.8,pain 10.0 ± 3.1,function 9.7 ± 2.2,activity 6.8 ± 1.2,muscle strength 6.7 ± 1.9,flexion deformity 5.4 ± 1.1,stability 5.6 ± 1.2,2 years after postoperative recovery to total HSS score 83.4 ± 5.2,pain 27.2 ± 2.5,function 19.5 ± 1.3,activity 11.6 ± 0.9,muscle strength 8.5 ± 0.9,flexion deformity 8.5 ± 0.9,and stability 8.1 ± 0.4.The total preoperative AKS clinical score was 35.6 ± 7.7,pain 17.7 ± 5.3,activity 10.5 ± 1.7,stability 12.3 ± 2.5 recovered to clinical total score 80.5 ± 4.8,pain 41.8 ± 3.0,activity18.5± 1.5,and stability 20.2 ± 1.1.The total preoperative AKS functional score was30.7 ± 7.8,doing walking 19.1 ± 4.3,and walking up stairs 15.7 ± 3.2.The total recovery at 2 years was 80.2 ± 5.1,walking 40.9± 2.5,and up stairs 39.3± 4.2.It can be seen that after TKA,all scores increased,and the patient basically had no pain or excessive activity after surgery,and the function and activity were greatly improved compared with before surgery.It corrected the valgus and valgus deformity,and the force line of the lower limbs was corrected.HSS score and AKS score can reflect TKA postoperative functional recovery,but AKS score is divided into two measures and clinical score and functional score,which can more reflect the surgical success rate and postoperative recovery of daily function,HSS score for patients after postoperative daily functional activity is not obvious,but both scores can reflect knee HA patients after TKA,the quality of survival.Conclusion: Patients with hemophilia knee arthritis underwent TKA and reduced the pain during the quality of life was improved.With the development of hematology prophylaxis,the occurrence of postoperative complications is decreased,so TKA surgery in patients with a reliable stage of hemophilia knee arthritis... |
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