Observational studyJournal of thrombosis and haemostasis : JTH2022
Postoperative bleeding complications in patients with hemophilia undergoing major orthopedic surgery: A prospective multicenter observational study.
Observational study in Journal of thrombosis and haemostasis : JTH, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.
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The trial behind it
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Who cites it
23 citing papers in PubMed, 1 synthesis or guideline pooled it, 39 citations in OpenAlex.
- Prosthesis survival situation and complications following total hip arthroplasty in hemophilic patients: a systematic review.BMC musculoskeletal disorders · 2025Pooled it
- Hemophilia increases risk of bleeding and thromboembolism after total shoulder arthroplasty.Clinics in shoulder and elbow · 2026Article
- Variables Affecting Periprocedural Haemostatic Response in Patients With Haemophilia: Real-World Retrospective Study.EJHaem · 2026Article
- A prospective cohort study develops and validates a machine learning model for predicting ecchymosis after total knee arthroplasty.Scientific reports · 2026Article
- Is Pharmacologic Prophylaxis for Venous Thromboembolism Necessary in People With Hemophilia After Total Knee and Hip Arthroplasty?The archives of bone and joint surgery · 2026Article
- Evaluating In-Hospital Safety and Perioperative Costs of Total Hip Arthroplasty in Super-Elderly Patients: A Nationwide Propensity Score-Matched Analysis in Japan.Journal of clinical medicine · 2025Article
- Efficacy and Safety of rVIII-SingleChain in Surgical Prophylaxis.Haemophilia : the official journal of the World Federation of Hemophilia · 2025Article
- Efficacy of corticosteroids addition to multimodal cocktail periarticular injection in total knee arthroplasty with hemophilic arthropathy.Scientific reports · 2025Article
- Article
- Total Shoulder Arthroplasty in Patients With Hemophilia A: Greater Odds of Postoperative Bleeding and Thromboembolic Events but No Difference in 5-year Implant Survival.Clinical orthopaedics and related research · 2025Article
- Comparative Efficacy and Safety of Intravenous vs. Combined Intravenous and Intraarticular Tranexamic Acid Administration in Total Knee Arthroplasty: A Stratified Analysis Based on Bleeding Risk.The archives of bone and joint surgery · 2025Article
- Transformative approaches in hemophilia management: from traditional therapies to prenatal stem cell treatment.Frontiers in bioengineering and biotechnology · 2025Review
- Total Hip Arthroplasty for Avascular Necrosis in a Patient With Hemophilia B.Arthroplasty today · 2024Article
- Anesthetic considerations for joint replacement surgery in hemophilic arthropathy: a comprehensive review.Anesthesia and pain medicine · 2024Review
- Clinical Efficacy of Intra-articular Tranexamic Acid Injection in the Management of Hemophilia with Total Hip Arthroplasty: A 24-month Retrospective Cohort Study.Orthopaedic surgery · 2024Article
- Article
- Occurrence rates and risk factors of in-hospital venous thromboembolism, major bleeding, and death in patients receiving fondaparinux after orthopedic surgery or trauma surgery.Irish journal of medical science · 2023Article
- Venous Thromboembolism in Total Hip and Total Knee Arthroplasty.JAMA network open · 2023Article
- Effect of recombinant human erythropoietin combined with iron sucrose on postoperative hemoglobin in patients undergoing artificial joint replacement.Scientific reports · 2023Article
- Thromboembolic Disease in Haemophilic Patients Undergoing Major Orthopaedic Surgery: Is Thromboprophylaxis Mandatory?Diagnostics (Basel, Switzerland) · 2022Review
Corrections and comments
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Authors and funding
15 authors at 11 institutions in 1 country.
Funding
Abstract
backgroundPersons with hemophilia (PWH) are at risk for chronic hemophilic arthropathy (HA). Joint replacement surgery may be used to relieve intractable pain and/or restore joint function.
objectivesThis multicenter, prospective, observational cohort study evaluated the rate of bleeding during the postoperative period after total hip (THA) or knee arthroplasty (TKA). PATIENTS/
methodsWe included PWH of any severity ≥18 years of age who were undergoing THA or TKA. Clinical decisions were made at the discretion of the treating physician according to local standards of care. Clinical data were prospectively recorded. Major bleeding was defined as bleeding in a critical site, bleeding that resulted in either a 2 g/dl or greater decrease in hemoglobin during any 24-h period, or transfusion of two or more units of packed red blood cells.
resultsOne hundred thirty-one procedures (98 TKA and 33 THA) were performed, 39 (29.8%) of which were complicated by major bleeding, including 46% of THA and 25% of TKA. The risk of major bleeding was increased in THA compared to TKA (OR 2.50, p = .05), and by the presence of an inhibitor (OR 4.29, p = .04), increased BMI (OR 4.49 and 6.09 for overweight and obese, respectively, compared to normal BMI, each p < .01), and non-use of an antifibrinolytic medication (OR 3.00, p = .03). Neither continuous clotting factor infusion (versus bolus infusion) nor pharmacologic thromboprophylaxis were associated with bleeding risk.
conclusionsThe bleeding risk remains substantial after THA and TKA in PWH, despite factor replacement. Use of antifibrinolytic medications is associated with decreased risk.
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