Total Knee Arthroplasty

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Abstract

SHS investigation development is considered from the geographical and historical viewpoint. 3 stages are described. Within Stage 1 the work was carried out in the Department of the Institute of Chemical Physics in Chernogolovka where the scientific discovery had been made. At Stage 2 the interest to SHS arose in different cities and towns of the former USSR. Within Stage 3 SHS entered the international scene. Now SHS processes and products are being studied in more than 50 countries.

Abstract

Total Knee Arthroplasty is one of the most performed procedures in the haemophilic population. Several series have been released over the last decades: despite good clinical outcomes, high rates of complications such as infection and loosening have been reported. Such complications have been mainly related to coinfected patients (HIV-positive) and subjects with inhibitors frequently affected by uncontrolled bleedings. Moreover, almost all arthroplasties have been performed using standard cemented Cobalt-Chrome knee implants and generally high constraints to ensure the stability of the prostheses. Recently new biomaterials with a better tribology and implants with less constraints have been used in haemophiliacs with encouraging results. The present mean survivorship is more than 90% at a mid-term follow-up while it was about 82.5% (range: 68%-96%) in the period ’70-‘90s. Dedicated multidisciplinary teams, appropriate bleeding management, and modern modular implants may ensure even better outcomes than the last decades with rates of success and complications very close to those of the non-haemophilic population.

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