Hemofili A Hastalarındaki Diz Artropatisi ve Bilateral Total Diz Artroplastisi Oranı

Amaç: Hemofili hastalarında epidemiyolojik olarak yapılan çalışmamızda, bir üniversite hastanesinin hematoloji-ortopedi ortak kayıtları kullanıldı. Bu çalışmanın amacı, diz problemleri olan orta ve ağır hemofili hastalarından elde edilen bilgileri, hastaların yaşı ve radyolojik açısından degerlendirmekti. Gereç ve Yöntemler: Retrospektif bir çalışma olup, iskelet-kas sistemi problemleri olan 130 hemofili A hastasından diz problemli 49’u bu çalısmaya dahil edildi. Kellgren-Lawrence(KL) sınıflaması, osteoartritlerin radyolojik degerlendirmesinde kullanıldı. Elektronik datalardan elden edilen bilgiler, sonuçları analiz etmek ve istatistiksel degerlendirmeler icin kullanıldı. Bulgular: Düz diz grafiği çekilmiş hastaların çoğunluğunda (27/39, %69,23), KL derecesi 3 veya 4 idi. KL derecesi ile hastaların yaşları arasında istatistiksel olarak anlamlı bir korelasyon mevcut idi (Spearman’s : rs = 0,512, p (2-tailed) = 0,001). Ayrıca, KL derecesi 4 olan 50 yas ve altında 7 hasta (%14,29) vardı. 49 diz problemi olan hastanın 25’inde (%51.02) total diz artroplasti (TDA) yapıldı ve bunların da 10 tanesi (%40) bilateral idi. Bilateral TDA icin ortalama yas (56.35), unilateral TDA dan (49.87) daha yüksekdi. Hastaların yaşı ile TDA olmaları arasında istatistiksel olarak anlamlı bir korelasyon vardi (Spearman’s: rs = 0,338, p = 0,017). 35 TDA yapılan hastada 2 revizyon tesbit edildi (%5.71). çalışmaya dahil edilen hastaların çogu (43/49, %87.75), profilaktik faktör tedavisi almaktaydı Sonuç: Çalışmamız, hemofili A hastalarındaki yüksek bilateral TDA oranını ve normal popülasyona gore bu grubunun ne kadar erken yasta KL 4 safhasına ilerlediklerini vurgulamaktadır. Bu sonuclar bize, bu grup hastalardaki tedavi yaklaşımının, yakin takibin ve profilaksinin önemini göstermektedir. Bu hastalardaki risk ve komplikasyonları azaltmak icin, tedavileri, tecrübeli merkezlerde ve özelleşmiş bir grup tarafından yapılmalıdır.

Anahtar Kelimeler:

Hemofili A, Total Diz Artroplastisi, Bilateral

Knee Arthropathy and Bilateral Total Knee Arthroplasty Ratio in Hemophilia A Patients

Objective:This epidemiological study was conducted in the joint haematology-orthopaedics clinic of a university hospital. The aim was to analyse the data in terms of age and radiology of patients with moderate or severe haemophilia A and knee involvement. Materials and Method:This was a retrospective study 49 patients with knee problems out of 130 haemophilia A and musculoskeletal problems. Kellgren-Lawrence (KL) classification was used for radiological assessments of osteoarthritis degree. Results:KL degree was 3 or 4 for most patients (27/39, 69.23%) in the group. There was statistically a meaningful correlation between KL degree and patients’ age (Spearman’s: rs = 0.512, p = 0.001). There were 7 patients with KL degree 4 at the age of 50 or younger (14.29%). 25 patients in 49(51.02%) had total knee arthroplasty(TKA) and 10(40%) of those was bilateral. Mean age for bilateral TKA(56.35) was higher than unilateral(49.87). There was a statistically meaningful correlation between patient age and the patients with TKA (Spearman’s: rs = 0.338, p = 0.017). There were 2 revision surgeries out of 35 TKA (5.71%). Most of the patients had prophylactic factor treatment (43, 87.75%). Conclusion: Our study signify the high ratio of bilateral knee replacements in haemophilia A patients and how early age they progressed to KL stage 4 comparing to normal population. These results show the importance of patient care in this group of patients, close follow-up and prophylactic treatment. They should be managed in experienced centres by an experience team to decrease the risks and complications.

Keywords:

HemophiliaA, Total knee arthroplasty, Bilateral,

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