A retrospective study of rehabilitation for patients with hemophilia knee osteoarthritis after total knee arthroplasty: a 10 year cohort study.

OBJECTIVE

Rehabilitation is an important means to help hemophilic arthropathy (HA) patients recover joint function after total knee arthroplasty (TKA). This article retrospectively analyzes the experience of rehabilitation therapy.

METHODS

We retrospectively analyzed cases from January 2011 to December 2021 in the Bone Injury Center Database of Zhejiang Provincial Hospital of Traditional Chinese Medicine. A total of 50 patients were included, classified according to preoperative range of motion (ROM): 14 with ROM between 0 and 45 degrees, 28 with ROM between 45 and 90 degrees, and 8 with ROM greater than 90 degrees. Recording knee joint function and complications from preoperative to postoperative 24 months.

RESULTS

Patients’ knee joint function improved after rehabilitation. The clinical and functional Knee Society Score (KSS) of 0°-45° group increased from 91.36 ± 7.91 to 102.25 ± 5.75 (P < 0.001), 45°-90° group increased from 102.25 ± 5.75 to 126.64 ± 6.97 (P < 0.001), 45°-90° group increased from 104.13 ± 2.80 to 128.00 ± 3.16 (P < 0.001). ROM of 0°-45° group increased from 54.07 ± 8.44 to 77.86 ± 8.20 (P < 0.001), 45°-90° group increased from 77.75 ± 9.59 to 90.43 ± 5.07 (P < 0.001), 45°-90° group increased from 103.25 ± 5.28 to 109.00 ± 5.58 (P < 0.001), and Visual Analogue Scale (VAS) of 0°-45° group decreased from 5.36 ± 1.01 to 3.86 ± 0.86 (P < 0.001), 45°-90° group decreased from 5.07 ± 0.98 to 3.64 ± 0.95 (P < 0.001), 45°-90° group decreased from 5.38 ± 0.74 to 3.88 ± 0.64 (P < 0.001). In a subgroup analysis, the patients with higher preoperative ROM have higher postoperative ROM and KSS. At the end of follow-up, patients with low preoperative ROM had higher VAS scores than other patients.

CONCLUSION

We recommend conducting a systematic evaluation and pre rehabilitation of patients before TKA surgery, and establishing their psychological expectations, followed by early initiation of postoperative rehabilitation. Furthermore, attention should be paid to psychological counseling for patients to enhance their awareness of autonomous rehabilitation. Additionally, monitoring clotting factor levels and promoting functional recovery of adjacent joints and soft tissues are also crucial aspects to consider.