primary total knee arthroplasty in hemophilia and allied disorders: revision rates and their causes

When patients with hemophilia and allied disorders (von willebrand disease and other congenital bleeding disorders) do not receive adequate primary hematologic prophylaxis from infancy, their joints will suffer knee joint degeneration; when such joint degeneration becomes very advanced (painful and disabling) despite previous conservative treatment, the only way to alleviate the problem will be to implant a primary total knee arthroplasty (tka). the literature has shown that twenty years after implantation, 71% of primary tkas are still functional; on the other hand, 18% have to be revised as a consequence of periprosthetic joint infection (pji). the main causes of revision total knee arthroplasty are pji and aseptic loosening (39% each). level of evidence: iii