Fortis doctors perform rare Bilateral Knee Replacement on a Hemophilia Patient

Bangalore, January 23, 2018: Doctors at Fortis Hospital, Bannerghatta Road successfully performed a rare bilateral knee replacement surgery on a 47-years-old man suffering from Hemophilia here recently. The resident from Chikkanna was suffering from severe pain in both his knees impairing his ability to perform daily work. His severe condition of Hemophilia, a genetic disorder that leads to profuse and unstoppable bleeding along with poor blood clotting following any injury, made this bilateral knee replacement a unique feat of clinical excellence. The team of doctors were led by Dr Narayan Hulse, Additional Director, Orthopaedics along with Dr Sachin Suresh Jadhav, Consultant, Hematology and Bone Marrow Transplant at Fortis Hospitals, Bannerghatta Road in Bangalore.

Earlier, the patient was admitted with complaints ofsevere pain, difficulty in bending knees affecting his walking capability andperform daily chores. After evaluating and trying various medications,bilateral knee replacement was the only treatment to cure him of this lingeringpain in his knees. However, the hemophilia condition made this a rare andchallenging case.

Hemophilia is a genetic bleeding disorder in which theblood does not clot properly risking the life of a hemophilia patient followinginjuries or surgery. Due to this condition, the patient was prone to      multiple joint bleeds or hemarthrosis sincebirth. These may be caused by minimal trauma and affects primarily joints likeknees, ankles and elbows. With recurrent hemarthrosis of knees, it caused jointdegeneration or hemophiliac arthropathy. With the help of some excellenttreatment plan of recovery by the doctors, the condition of hemophilia wasimpeccably managed and the knee replacement was done without any complications.The clinical excellence of the case was proved when the patient recoveredcompletely. 

Dr NarayanHulse, Senior Orthopaedic surgeon and Additional Directorof Orthopaedics, Fortis Hospital, Bannerghatta Road, Bangalore said, “Thepatient had severe hemophilia destruction ofthe knee joints which had affected his basic activities of dailyliving. Therefore, there was an urgent need for knee replacement surgery.Generally, the knee replacement surgery is performed on people above the age of60 but in this case due to repetitive bleeding in the joint, hisjoints were damaged at an early age with severe disabilities. Onlysensible way to help him was to conduct a knee replacement. However,performing surgery was a complicated task in him, becauseof the potentially fatal bleeding risk. He had severe deformity(bending) of his knees, which required more surgical time, more bleeding andsurgical difficulties. To normalise the blood clotting factors in his body,we performed a clotting factor replacement therapy (infusingartificial blood factor into the veins) before the surgery. Thisbrought in confidence between us and the patient to proceed with thetreatment.”  

Dr Sachin SureshJadhav, Consultant in Hematologist, Bone Marrow Transplant, Fortis Hospitals,Bannerghatta road said, Patient’s knee replacement surgery was a challenging task butthe team of hematologists, lab, surgeons and the physiotherapists workedtogether to make it possible. We were extra careful regarding the internalbleeding in this case considering the condition of the patient. The bloodfactor injections were given to the patient two times a day for about 14 daysto avoid any risk of internal bleeding. Simultaneously, we startedphysiotherapy to mobilize the leg movements which also played a big role in therecovery of the patient.” 

Thepatient, Mr Chikkana said, “I was suffering fromHemophilia since birth. However, my condition became severe when Iwas unable to walk and suffered severe pain, day andnight.  My knee replacement surgery went well. I amthankful to the team of Fortis hospitals who treated me well. I am recoveringfast and will be visiting to the doctors for routine checkup.” 

Accordingto the World Federation of Hemophilia (WFH), India has the second highestnumber of global patients with hemophilia A where most of thepatients remain undiagnosed. This calls for more education andsurveillance to the mass for prevention and care of this disease.

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