Hamostaseologie 2019; 39(04): 377-382
DOI: 10.1055/s-0039-1677884
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Current Trend of Invasive Orthopaedic Interventions for People with Haemophilia in Romania: Single Centre Experience

Margit Serban
1  Department of Hemato-Oncology, Emergency Children's Hospital “Louis Turcanu,” European Haemophilia Treatment Center, Timisoara, Timis, Romania
,
Dan Vasile Poenaru
2  Department of Orthopaedics, University of Medicine and Pharmacy “Victor Babes,” Timisoara, Timis, Romania
,
Jenel Marian Patrascu
2  Department of Orthopaedics, University of Medicine and Pharmacy “Victor Babes,” Timisoara, Timis, Romania
,
Ladislau Ritli
3  Department of Pediatric Hemato-Oncology, University of Medicine and Pharmacy, County Hospital, Oradea, Bihor, Romania
,
Eugen Boia
4  Department of Pediatric Surgery, University of Medicine and Pharmacy “Victor Babes,” Timisoara, Timis, Romania
,
Delia Maria Mihailov
5  Department of Paediatrics, University of Medicine and Pharmacy “Victor Babes,” Timisoara, Timis, Romania
,
Cristina Emilia Ursu
1  Department of Hemato-Oncology, Emergency Children's Hospital “Louis Turcanu,” European Haemophilia Treatment Center, Timisoara, Timis, Romania
,
Delia Savescu
6  Department of Laboratory, Children's Emergency Hospital “Louis Turcanu,” Timisoara, Timis, Romania
,
Ioana Ionita
7  Department of Hematology, University of Medicine and Pharmacy “Victor Babes,” Timisoara, Timis, Romania
,
Adina Traila
8  European Hemophilia Treatment Center, Medical Center for Children and adolescents “C. Serban” Buzias, Timis, Romania
,
Simona Cerbu
9  Department of Radiology, University of Medicine and Pharmacy “Victor Babes,” Timisoara, Timis, Romania
,
Estera Boeriu
10  Department of Pediatric Hemato-Oncology, University of Medicine and Pharmacy “Victor Babes,” Timisoara, Timis, Romania
,
Cristian Jinca
10  Department of Pediatric Hemato-Oncology, University of Medicine and Pharmacy “Victor Babes,” Timisoara, Timis, Romania
,
Wolfgang Schramm
11  Rudolf Marx Stiftung Bluterbetreuung Bayern e. V. (BBB) - Universität München Germany
,
Smaranda Arghirescu
10  Department of Pediatric Hemato-Oncology, University of Medicine and Pharmacy “Victor Babes,” Timisoara, Timis, Romania
› Author Affiliations
Further Information

Publication History

29 March 2018

23 December 2018

Publication Date:
13 February 2019 (online)

Abstract

Objective In countries with low factor concentrate consumption, disabling joint disease remains the major morbidity in patients with haemophilia. The objective of the present analysis is to express the trend and profile of invasive orthopaedic interventions in our country with low usage of factor replacement, lacking the prophylaxis program until recent years.

Patients and Methods This retrospective descriptive study was conducted in our university centre in Timisoara with long-lasting experience in haemophilia care, which succeeded in developing an exceptionally valuable genuine comprehensive inter-institutional cooperation. This study refers to 115 invasive interventions performed on 97 patients: 83 with haemophilia A, 10 with haemophilia B and 4 with von Willebrand disease in the period of 2001 to 2017; 17 of them had inhibitors, 5 developing inhibitors after the intervention.

Results and Discussion The cohort of patients consisted mostly of young adults, aged between 7 and 49 years. The vast majority of them, 91.3% of the patients, had the burden of severe chronic arthropathy. This was the reason for 95 interventions, with programmed solution. In 20 cases the cause of invasive interventions was emergency. Knee and hip replacement represented 28% of the major interventions. The complications we encountered were excessive bleeding (12.2%), infection (13%) and inhibitor development (4.3%).

Conclusion Surgery is a demanding intervention in patients with haemophilia, which unfortunately cannot be ignored in our country. Hopefully, the improved availability and accessibility to replacement therapy will eliminate the necessity of these interventions, optimizing the outcomes for the next generations.