Long-term prosthesis survival of total hip and total knee arthroplasty in people with inherited bleeding disorders.

Authors

Gijs Aertssen, Huub M de Visser, Wouter Foppen, Roger E G Schutgens, Merel A Timmer, Lize F D van Vulpen

Published in

Research and practice in thrombosis and haemostasis. Volume 10. Issue 5. Pages 106887. Epub Jul 28, 2026.

Abstract

Joint arthroplasty provides pain relief and functional improvement, but higher peri- and postoperative risks in people with bleeding disorders historically lead to lower prosthesis survival rates (PSRs) than in the general population. Long-term outcomes after advances in hemophilia care remain unclear. In people with bleeding disorders, PSR is 84.0% at 15 years after total knee arthroplasty (TKA) and 91.9% at 5 years after total hip arthroplasty (THA), compared with 92.8% and 93.7% in the general population.
To determine PSRs of TKA and THA up to 25 years after surgery in people with end-stage hemophilic arthropathy and to identify predictors for prosthesis failure.
This single-center study analyzed routine-care data of people with bleeding disorders (1989-2025), with first revision as the endpoint. PSRs and predictors were assessed using Kaplan-Meier and Cox proportional hazards models. Complete follow-up data on pre-, peri- and postoperative characteristics were evaluated; all variables with a univariable P < .1 were included in multivariable models.
A total of 128 TKAs and 64 THAs were included. The PSR for TKA in people with bleeding disorders was 92.2% (number at Risk [nR] = 71; 95% CI, 87.5-97.3) after 15 years and 90.9% (nR = 28; 95% CI, 85.5-96.6) after 25 years. The PSR for THA in people with bleeding disorders was 91.0% (nR = 27; 95% CI, 82.8-100) after 15 years and 78.6% (nR = 14; 95% CI, 64.8-95.5) after 25 years. Prosthetic joint infection, more common in patients with an inhibitor, predicted TKA failure. A cemented femoral stem, associated with a higher age, predicted THA failure.
The prothesis survival rate of TKA and THA for people with bleeding disorders with end-stage hemophilic arthropathy was comparable to that of the general population in the literature.

PMID:
42633224
Bibliographic data and abstract were imported from PubMed on 23 Aug 2026.

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