Document Detail


Orthopedic procedures in patients with congenital coagulation disorders: single center experience.
MedLine Citation:
PMID:  24662907     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background. Spontaneous intraarticular bleeds in congenital coagulation disorders result in early and extensive damage to the joints and periarticular structures. Total arthroplasty is the only effective method of treating these defects. Interim surgical procedures (arthroscopy, osteotomy, etc.) exist that can postpone arthroplasty, especially considering the fact that the condition affects young people. The aim of this paper is to discuss the range of trauma care and orthopedic procedures performed in patients with congenital coagulation disorders. Also presented are early results of joint arthroplasty in these patients. Material and methods. A total of 168 trauma care and orthopedic procedures were performed in patients with congenital coagulation disorders at the Clinical Department of Orthopedics and Traumatology of the Central Clinical Hospital of the Ministry of Interior in Warsaw in the years 2010-2013. Among them were total arthroplasties (79 arthroplasties of the knee, 30 of the hip, 3 of the ankle and 1 of the elbow), arthroscopies, filling bone cysts with grafts and trauma procedures. The HHS, KSS, AOFAS and MEPS scales were used to evaluate the respective clinical results of hip, knee, ankle and elbow arthroplasty procedures. A VAS was used to evaluate pain intensity. In knee arthroplasty patients, quality of life parameters were evaluated with the WOMAC index. Results. In patients post hip arthroplasty, HHS scores increased by 50.22 points and VAS scores increased by 6.34 points. An increase of 116.41 points in KSS scores and 6.67 points in VAS scores was recorded in patients after knee arthroplasty. Also, WOMAC scores improved by 53.8 points after surgery. Evaluation of early results of ankle arthroplasty in the AOFAS scale showed a mean improvement of 35.5 points and a 5-point improvement in VAS scores. MEPS scores, used for evaluation of elbow arthroplasty results, improved from 15 to 70 points, with an improvement from 6 to 2 points in VAS scores. Conclusions. 1. Orthopedic procedures in patients with congenital coagulation disorders require thorough preparation of the patient and close cooperation between the orthopedic and hematological teams. 2. Early clinical outcomes are promising. 3. Decreased pain intensity, increased joint range of motion and improved quality of life post-surgery are observed.
Authors:
Ireneusz Kotela; Piotr Zbikowski; Paweł Ambroziak; Andrzej Kotela; Jacek Lorkowski; Ewa Stefańska-Windyga; Piotr Wojdasiewicz; Filip Latawiec; Jerzy Windyga
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Ortopedia, traumatologia, rehabilitacja     Volume:  15     ISSN:  2084-4336     ISO Abbreviation:  Ortop Traumatol Rehabil     Publication Date:  2013 Oct 
Date Detail:
Created Date:  2014-03-25     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101240146     Medline TA:  Ortop Traumatol Rehabil     Country:  Poland    
Other Details:
Languages:  eng     Pagination:  601-16     Citation Subset:  IM    
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