ORTHOPEDIC-SURGERY IN HEMOPHILIA - 20 YEARS EXPERIENCE IN SWEDEN

At the International Hemophilia Center, Malmo, Sweden, which serves a large proportion of the Swedish hemophilia population, 98 orthopaedic surgical procedures were performed from 1970 to 1989 in 66 patients ra nging in age from 6 to 71 gears, The most common procedures were knee synovectomy, elbow synovectomy in combination with resection of the ra dial head, and total hip replacement, Comparing the 2 decades of the p eriod, 3 differences were observed: a decreasing need of surgery, an i ncreasing average age of the patients, and a change in the kinds of op erations performed, Knee synovectomy and achillotenotomy were most fre quent during the 1970s, whereas elbow synovectomy with resection of th e radial head and total hip replacement were most frequent during the 1980s, Owing to the availability of regular factor replacement therapy as practiced at the Malmo Center, the situation of patients with hemo philia has improved dramatically during the last 2 decades, In the aut hors' opinion, it is now possible to avoid hemophilic arthropathy almo st completely by giving effective continuous prophylaxis from an early age, In all likelihood, this is the explanation of the changing pictu re of orthopaedic surgery in patients with hemophilia today.