Risk factors associated with invasive orthopaedic interventions in males with haemophilia enrolled in the Universal Data Collection program from 2000 to 2010

摘要

Background Invasive orthopaedic interventions ( IOI ) are often used to control recurrent haemarthrosis, pain and loss of joint function, in males with haemophilia (Factor VIII and Factor IX deficiency). Aim Identify risk factors associated with IOI s in males with haemophilia enrolled in the Universal Data Collection ( UDC ) surveillance program from 2000 until 2010. Methods Data were collected on IOI s performed on patients receiving care in 130 haemophilia treatment centers in the United States annually by health care providers using standardized forms. IOI s included in this study are as follows: 1) synovectomy and 2) arthrodesis or arthroplasty (A/A). Information about potential risk factors was obtained from the preceding UDC visit if available, or from the same visit if not. Patients with no reported IOI at any of their UDC visits were the reference group for the analysis. Multivariate analyses were conducted to identify independent risk factors for synovectomies and arthrodesis/arthroplasty. Results Risk factors significantly associated with the two IOI categories were age, student status, haemophilia severity, number of joint bleeds within the last 6?months, HIV or hepatitis C ( HCV ) status. Multivariate analyses showed patients on continuous prophylaxis were 50% less likely to have had a synovectomy and were 40% less likely to have an A/A. Conclusions This study shows modifiable risk factors, including management of bleeding episodes with a continuous prophylactic treatment schedule are associated with a decreased likelihood of IOI s in males with haemophilia.