Activities of Daily Living and Quality of Life After Orthopaedic Surgery for Haemophilic Arthropathy: A Scoping Review.

INTRODUCTION

Haemophilic arthropathy causes chronic pain and disability. While orthopaedic surgery aims to alleviate these, post-surgical activities of daily living (ADL) and quality of life (QOL) outcomes lack systematic review.

AIM: To assess ADL and QOL outcomes after orthopaedic surgery for haemophilic arthropathy and identify research gaps.

METHODS

This scoping review searched MEDLINE, Embase, CENTRAL, CINAHL, and PEDro for studies reporting ADL or QOL outcomes in patients undergoing lower-limb orthopaedic surgery for haemophilic arthropathy. Data were qualitatively synthesised.

RESULTS

Sixteen studies were included, predominantly on total knee arthroplasty (n = 11). The SF-36 was widely used, whereas haemophilia-specific tools were rare. Despite heterogeneous designs, varied follow-ups, and inconsistent mental health results, most studies demonstrated significant post-surgical improvements in physical function and QOL.

CONCLUSION

While standardised, disease-specific assessments are needed, this review confirms surgery consistently improves ADL and QOL. However, it should be noted that it is well known that, in a disease as rare as haemophilia, it is very difficult to conduct Level I evidence studies on orthopaedic surgery (prospective, double-blind, randomized trials). In fact, this study confirms what was already well known empirically: that orthopaedic surgery is effective in relieving or eliminating joint pain thereby improving the QOL for patients with advanced haemophilic arthropathy who have not responded to non-surgical treatment.