A New Study Has Identified Why Patients With Hemophilia Have Such High Rates of Prosthetic Joint Infection and What Can be Done About It


The Orthopaedic Institute for Children (OIC) has found that improving the education of patients with hemophilia leads to a large reduction in rates of prosthetic joint infection, reports Bioportfolio.
Hemophilia is an unusual condition that prevents blood from clotting. Patients with the disease lack substances known as clotting factors that mix with platelets to make blood sticky. This means that the blood of people with hemophilia is less likely to clot and bleeding often continues for a long time. Patients with the condition can have prolonged nosebleeds, bleeding gums, frequent bruising, and stiffness and pain in joints caused by internal bleeding. The severity of symptoms differs between individuals. Many patients also develop arthritis at a young age as a secondary effect of the disease, and this can make joint replacements necessary.

Patients with hemophilia who undergo joint replacement surgery have significantly higher rates of infection in their prosthetics compared to non-hemophiliac patients. If a patient develops an infection they usually have to undergo implant removal and reinsertion to treat it, and if the infection re-occurs then, in serious cases, amputation is necessary. The reasons for the raised infection rates in hemophiliac patients have been unclear, with many arguing that it is a side effect of the immune suppression that those with the condition often have. However, new research carried out at OIC in Los Angeles suggests that the problem is actually patient education.

The OIC has been on the cutting-edge of hemophilia research for several decades. The centre’s innovative approach of treating hemophilia patients led to its designation in 1970 as an International Hemophilia Training Center. Since then the OIC has continued its focus on improving treatments for hemophilia through research and a high quality of patient care.

To investigate the OIC doctors’ theory that patient education is behind the high infection rates, the center instituted a comprehensive education program about IV self-infusion for patients and tracked their subsequent infection rates. Thirty-two hemophiliac patients underwent joint replacement following the start of the study in 2005. The results showed a significant improvement, with a reduction of joint replacement infection rates from 17% to 0%. These results emphasize the importance of patient education and show that even if immune suppression exacerbates infection rates, it is not the primary cause of the high levels in hemophilia patients.
The results of this study show the crucial role that patient education plays in prosthetic joint infection rates, and highlights the improvements that could be made in this area. The findings will be presented and discussed at the World Federation of Hemophilia’s annual meeting taking place next month in Glasgow.

Anna Hewitt

Anna Hewitt

Anna is from England and recently finished her undergraduate degree. She has an interest in medicine and enjoys writing. In her spare time she likes to cook, hike, and hang out with cats.

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