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Special Features of Total Knee Replacement in Hemophilia
Patellar Prosthetic Component
There is dispute about whether the patella should be resurfaced in TKR. Studies other that those referenced above indicate that the patella should be routinely resurfaced in osteoarthritis (OA). In hemophilia patients, as in the case of patients with inflammatory diseases (rheumatoid arthritis), implanting a prosthetic patella component (patellar resurfacing) is often advisable. However, in nonhemophiliac patients, there is considerable controversy over whether or not the patellar resurfacing should be performed. In fact, the literature dealing with OA of the knee tends to suggest that the patella should not be resurfaced. In general, for hemophilia patients, a patellar resurfacing of polyethylene attached to the patella using antibiotic-loaded bone cement is advisable. The author's personal view is that the patella should be resurfaced in TKR in patients with hemophilia.
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