Опыт эндопротезирования в лечении гемофилической артропатии

We report our experience of 675 (616 primary, 59 revision) joint replacements in 425 patients performed in one hospital. There were 383 patients with hemophilia A and 42 patients with hemophilia B (age from 18 to 76 years). Inhibitor was detected in 18 hemophilia patients. 90% of patients had positive antibodies to hepatitis C (anti-HCV+), 3 patients had HIV infection. There were 552 knee, 115 hip, 5 shoulder and 3 elbow replacements. 23 knee and 3 hip replacements were performed in hemophilia patients with inhibitor. The average follow-up of implants was 6 years (from 4 months to 20 years). There were revision replacements in 8.8% of cases: 5.5% patients with aseptic loosening and 3% patients – with deep infections. In hemophilia patients deep infection occurred much more frequent – 11%. The significantly higher rate of complications (11%) was observed in patients with inhibitors. In spite of elevated risks for the development of complications in hemophilia patients joint replacement is the only effective procedure in the treatment of end-stage arthropathy. Hemophilia patients need an individualized approach in providing hemostasis and prophylactic antibacterial therapy.