Twenty-four total knee arthroplasties were performed in fourteen
disabled patients with hemophilia. The average age of the patients at
operation was thirty-five years. Twenty-one of the implants that were used
were total condylar prostheses. Using The Hospital for Special Surgery
knee-rating system after two to nine years of follow-up, the result in
fifteen knees was rated as excellent; in six, as good; and in one, as fair.
Two patients had a poor result that was attributable to late infection.
Pain and function were markedly improved, and the average gain in range of
motion was 23 degrees. Postoperative complications, in addition to the
infections, included one subcutaneous hematoma, one hemolytic anemia, and
one instance of inhibition to Factor VIII. The technical problems in
treatment were formidable. Total knee arthroplasty in a hemophiliac can be
successful, but it should be performed only with strict hematological
supervision. The surgeon should be prepared to treat many potential