Dear Jose
This is a very rare and difficult case. In UK the routine is that such cases go to specialised centres where the Haematology Department is fully supporting the Surgery and they them selves have such protocols. I do not have personal experience as in my life I saw only two cases and I have referred them to these guys. Discussing your case I was told about the monograph published by the World federation of Haemophilia.
Please find below the reference.
Jerome Wiedel, Sally Stabler, Sue Geraghty, Sharon Funk (2010). Joint Replacement Surgery in Hemophilia. Monograph in Treatment of Hemophilia. World Federation of Hemophilia, Montréal, Québec , Canada. No: 50, 1-17
Also I will try to attach a file with the protocol which I found from another colleague.
Dear Jose,
This is a rare and difficult case. Such cases in UK are sent to special centres where there is a lot of support by the Haematology Department and they do the protocols. Personally I have no experience as within my 28 years career I had only two patients suffering from haemophilia and they were of need of a total knee, so I had referred them. I found though that the World Federation of Haemophilia have some recent guidelines.
Please find attached the reference
Jerome Wiedel, Sally Stabler, Sue Geraghty, Sharon Funk (2010) Joint Replacement Surgery in Hemophilia. Hemophilia Monographs, Published in Treatment of Hemophilia NO 50 World Federation of Hemophilia, Montréal, Québec, Canada, 50, 1-17
There is also attached a file with a protocol found by a colleague in India
Sorry for the two entries but my computer had a problem and I thought the first was not published. Apologies for this.
Yes, difficult cases. Anyway,the results are worth doing it. Cooperation with haematologist for substitutional therapy with the factor which is absent in the individual case is indispensable (timing, dosage, time to discontinue, good lab control). Please, see some references below.
http://www1.wfh.org/publication/files/pdf-1210.pdf
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3360184/
http://www.sciencedirect.com/science/article/pii/S0883540315005276
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