Outcomes of total hip and knee arthroplasty in patients with haemophilia: a meta-analysis of comparative studies and clinical practice recommendations

Challoumas, D., Munn, D., Jeyakumar, G., Bagot, C., Rodgers, R., Kearns, R. and Jones, B. (2024) Outcomes of total hip and knee arthroplasty in patients with haemophilia: a meta-analysis of comparative studies and clinical practice recommendations. Haemophilia, 30(1), pp. 180-194. (doi: 10.1111/hae.14904) (PMID:38082543)

Abstract

Aim: We aimed to compare the outcomes of total hip and knee arthroplasty (THA, TKA) in haemophilic patients compared to matched controls. Methods: Through a literature search we identified all cohort studies comparing perioperative complications and other outcomes of THA and TKA in haemophilic patients and matched controls without haemophilia. Results of the same outcome measure assessed by two or more studies were pooled in meta-analyses; odds ratios (ORs) with 95% confidence intervals (CI) were calculated. The risk of bias in included studies and certainty of evidence of each result were assessed using the Newcastle-Ottawa scale and the GRADE tool respectively. Results: A total of five retrospective studies with matched controls were included; four of them were of good and one of fair quality. Based on moderate certainty evidence, compared to matched controls, patients with haemophilia had a significantly higher incidence of the following complications after a) TKA: periprosthetic joint infection [PJI; OR 1.6 CI (1.3, 1.9)], 1-year revision/re-operation [OR 1.4 CI (1.2, 1.8)] and b) THA: major and minor 90-day complications [major OR 2.2 CI (1.7, 2.9); minor OR 1.4 CI (1.1, 1.8)], venous thromboembolism [OR 3.1 CI (2.1, 4.6)]. PJI incidence in THA was not different in haemophilia compared to controls [OR 1.5 CI (.9, 2.6)]. Conclusion: Our results can be used by healthcare professionals counselling patients with haemophilia considering a THA or TKA as part of the informed consent process. We provide detailed clinical recommendations for the perioperative management of THA and TKA in haemophilic patients.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Jeyakumar, Dr Gowsikan and Munn, Dr David and Kearns, Dr Rachel and Challoumas, Mr Dimitris and Rodgers, Dr Ryan and Jones, Mr Bryn and Bagot, Dr Catherine
• Authors: Challoumas, D., Munn, D., Jeyakumar, G., Bagot, C., Rodgers, R., Kearns, R., and Jones, B.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Infection & Immunity; College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: Haemophilia
• Publisher: Wiley
• ISSN: 1351-8216
• ISSN (Online): 1365-2516
• Published Online: 11 December 2023
• Copyright Holders: Copyright © 2023 John Wiley & Sons Ltd.
• First Published: First published in Haemophilia 30(1): 180-194
• Publisher Policy: Reproduced in accordance with the publisher copyright policy