{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:05:13Z","timestamp":1787501113185,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T00:00:00Z","timestamp":1635897600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Haemophilic arthropathy is a serious complication of haemophilia often requiring surgical intervention. It is unclear whether advances in comprehensive care are associated with a reduction in orthopaedic interventions and peri\u2010procedural resource utilization.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To determine temporal patterns of orthopaedic interventions in persons with haemophilia (PWH), and evaluate changes in healthcare utilization and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this Canadian multicentre retrospective cohort study, adult PWH from Northern Alberta and British Columbia who underwent orthopaedic procedures (1990\u20102018) were included. Temporal changes in the type of procedures, length of stay (LOS), factor utilization and outcomes were examined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      : Sixty\u2010five patients (78% haemophilia A) underwent 102 surgeries at a median age of 46.3. Of the 46 severe PWH, 28 (61%) were on prophylaxis at time of surgery. The proportion of total knee arthroplasties (TKA) declined over time (56% 1990\u20131999, 51% 2000\u20132009, 27% 2010\u20132018), with a concomitant rise in ankle arthrodesis (0% 1990\u20131999, 18% 2000\u20132009, 27% 2010\u20132018). Over time, PWH underwent orthopaedic procedures at an older age (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.02). There was a significant reduction in perioperative factor VIII utilization (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0=\u00a0.003) and median LOS (\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&lt;\u00a0.0001). Major bleeds, prosthetic joint infections and thrombosis were not observed in the last decade.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In the last three decades, there was a decline in the proportion of TKA, likely reflecting the impact of widespread use of tertiary prophylaxis. However, ankle arthrodesis rates increased, suggesting that higher trough levels may be required to prevent ankle arthropathy. We observed a significant reduction in LOS and factor utilization, reflecting improvements in perioperative management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.14451","type":"journal-article","created":{"date-parts":[[2021,11,3]],"date-time":"2021-11-03T09:30:28Z","timestamp":1635931828000},"page":"151-157","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Trends of outcomes and healthcare utilization following orthopaedic procedures in adults with haemophilia: A 3\u2010decade retrospective review"],"prefix":"10.1111","volume":"28","author":[{"given":"Chu Yang","family":"Lin","sequence":"first","affiliation":[{"name":"Faculty of Medicine and Dentistry University of Alberta  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farshad","family":"Hosseini","sequence":"additional","affiliation":[{"name":"Department of Medicine University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Squire","sequence":"additional","affiliation":[{"name":"Providence Health Care Vancouver  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"Jackson","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Medicine University of British Columbia  Vancouver Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0205-9722","authenticated-orcid":false,"given":"Haowei (Linda)","family":"Sun","sequence":"additional","affiliation":[{"name":"Division of Hematology Department of Medicine University of Alberta  Edmonton Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,11,3]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm6070063"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12644"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.2147\/JBM.S50644"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2015.06.015"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2012.02843.x"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12878-015-0022-8"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12391"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12932"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2141.2009.07613.x"},{"issue":"2","key":"e_1_2_12_11_1","doi-asserted-by":"crossref","DOI":"10.2106\/JBJS.OA.19.00085","article-title":"In\u2010hospital complications and readmission in patients with hemophilia undergoing hip or knee arthroplasty","volume":"5","author":"Chiasakul T","year":"2020","journal-title":"JB JS Open Access"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.05.062"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.13140"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2011.02552.x"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1423-0410.2012.01653.x"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2012.02909.x"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2016.01.012"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2008.01876.x"},{"issue":"6","key":"e_1_2_12_19_1","first-page":"260","article-title":"A 13\u2010year review of elective orthopaedic surgery outcomes in patients with hemophilia A and B","volume":"61","author":"Hosseini F","journal-title":"BC Medical 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