In uncorrectable painful deformities, it becomes necessary to perform either of two procedures. It is difficult to decide when to perform arthrodesis and when to do total joint replacement. Individual assessment should be carried out to aid in decision making. The treatment options should be discussed with the patient after evaluating his needs and expectation.
Most common indication for surgery is disabling pain. If involvement is unilateral and the opposite lower limb is relatively normal, arthrodesis is a good option.
Total joint replacement in bilateral knees is indicated with Stage IV or Stage V arthropathy when persistent knee pain is presesent.
Total hip replacement is indicated in Stage IV or Stage V hemophilic arthropathy when pain is persistent with severe disability not relieved by conservative measures. Arthroplasty of the elbow has been reported.
Arthrodesis of the ankle, subtalar and midtarsal joints in the foot, shoulder, or knee may be indicated when these joints are destroyed. The surgical technique is the same as in normal patients with the exception that percutaneous pins should not be utilized in hemophiliacs.
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This website has been very informative. I have a brother and three nephews who are haemophilic patients.
I am very concern about my brother who is forty years old, lives in New York and is suffering with pain in his ankle. His situation is becoming very disabling but he does not know where to turn for proper treatment. He has been told by three doctors that, he could lose his foot if he does surgery. However, your web site has given me some hope.
The orthopedic surgeon in Jamaica( his original home) says he needs to find a treatment center immediately because the ultra sound results are not looking good. Where can we find one? Please, Help!
Dr Arun Pal Singh Reply:
October 3rd, 2010 at 7:27 am
@Stephaney Bodley,
What treatment center.
What has happened to the foot and why there is talk about loosing the foot.
What is wrong with ultrasound?
What treatment centers you are looking for?