Document Detail


Knee joint arthroplasty in a patient with haemophilia A and high inhibitor titre using recombinant factor VIIa (NovoSeven): a new case report and review of the literature.
MedLine Citation:
PMID:  11380637     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Elective orthopaedic surgery is regularly withheld from patients with haemophilia and high inhibitor titre despite the presence of severe arthropathy and urgent medical need. A knee joint arthroplasty was performed in a patient with severe haemophilia A and a high inhibitor titre using recombinant factor VIIa (rFVIIa) as the sole coagulation factor. There was no abnormal bleeding during surgery although an increased blood loss through surgical drains did occur during the first 6 h postoperatively. Rehabilitation was started on day 1 and continued for 3 months. Walking commenced on day 4. After 1 year of follow-up, the clinical outcome of surgery was considered excellent with no pain, knee mobility at 0-5-90 degrees, and an International Knee Society score of 95/100. No rFVIIa-associated side-effects or thrombotic complications were reported. In conclusion, knee joint arthroplasty is now an option for haemophilia patients with a high inhibitor titre. An international review of all available data on elective orthopaedic surgery in inhibitor patients is required so that the optimal treatment regime can be defined and the short- and long-term risk-benefit ratio of surgery compared to that of noninhibitor patients.
Authors:
A Faradji; F Bonnomet; J Lecocq; L Grunebaum; D Desprez; O Kern; L Barbier; J Sibilia
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Publication Detail:
Type:  Case Reports; Journal Article; Review    
Journal Detail:
Title:  Haemophilia : the official journal of the World Federation of Hemophilia     Volume:  7     ISSN:  1351-8216     ISO Abbreviation:  Haemophilia     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-05-30     Completed Date:  2001-12-04     Revised Date:  2009-10-21    
Medline Journal Info:
Nlm Unique ID:  9442916     Medline TA:  Haemophilia     Country:  England    
Other Details:
Languages:  eng     Pagination:  321-6     Citation Subset:  IM    
Affiliation:
Haemophilia Regional Centre, University Hospital Hautepierre, Strasbourg, France. albert.faradji@chru-strasbourg.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Arthroplasty, Replacement, Knee / rehabilitation*
Blood Loss, Surgical / prevention & control
Factor VIIa / administration & dosage*
Hemophilia A / drug therapy,  immunology,  surgery*
Humans
Isoantibodies / blood
Male
Recombinant Proteins / administration & dosage
Chemical
Reg. No./Substance:
0/Isoantibodies; 0/Recombinant Proteins; EC 3.4.21.21/Factor VIIa

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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