{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:55:01Z","timestamp":1790571301388,"version":"4.1.0"},"reference-count":28,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T00:00:00Z","timestamp":1763424000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Haemophilia"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>Knee arthropathy affects 90% of patients with severe haemophilia, with unique morphological changes making TKA technically challenging. We evaluated morphological features of haemophilic knees compared to osteoarthritic controls and provide evidence\u2010based surgical recommendations.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We evaluated 16 haemophilic patients undergoing TKA with 18 gender\u2010matched non\u2010haemophilic OA patients. This represents the largest intraoperative morphometric study of haemophilic knees to date. Morphological indices including femoral mediolateral width (fML), femoral anteroposterior length (fAP), tibial mediolateral width (tML), tibial anteroposterior length (tAP), and intercondylar notch size were assessed using sterile callipers intraoperatively. Clinical correlation with component sizing, surgical technique modifications (femoral component rotation adjustments, modified notch preparation, soft tissue balancing), and early outcomes were analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The haemophilic group exhibited significantly greater fML (78.21\u00a0\u00b1\u00a05.34 vs. 70.41\u00a0\u00b1\u00a04.34\u00a0mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.005) and higher aspect ratio (ML\/AP: 1.33\u00a0\u00b1\u00a00.05 vs. 1.20\u00a0\u00b1\u00a00.04,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.03) compared to OA controls. Haemophilic patients had significantly larger intercondylar notch (19.23\u00a0\u00b1\u00a01.2 vs. 14.2\u00a0\u00b1\u00a01.56\u00a0mm,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.03) and more external rotation based on posterior condylar axis (4.1\u00a0\u00b1\u00a00.05 vs. 3.2\u00a0\u00b1\u00a00.03 degrees,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.03). These differences resulted in component size selection changes in 75% of cases (12\/16) and required surgical technique modifications including altered femoral component rotation in 68.75% of cases (11\/16).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Haemophilic knees demonstrate distinct morphological characteristics with practical implications for TKA. Modified surgical techniques accommodating wider mediolateral dimensions and altered rotational dynamics can be implemented with existing implants and standard instrumentation. These observations may inform the estimated 1200\u20131500 haemophilic TKAs performed annually worldwide, though multicentre validation is needed.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.70164","type":"journal-article","created":{"date-parts":[[2025,11,18]],"date-time":"2025-11-18T13:26:47Z","timestamp":1763472407000},"page":"239-245","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Morphological Variations in Haemophilic Knee Arthropathy: Surgical Implications for Total Knee Arthroplasty Component Selection and Bone Preparation"],"prefix":"10.1111","volume":"32","author":[{"given":"Seyed Mohammad Javad","family":"Mortazavi","sequence":"first","affiliation":[{"name":"Joint Reconstruction Research Center Tehran University of Medical Sciences  Tehran Iran"},{"name":"Department of Orthopedic Surgery Imam Khomeini Hospital Complex Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Haghpanah","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery Kashan University of Medical Sciences  Kashan Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadreza","family":"Razzaghof","sequence":"additional","affiliation":[{"name":"Joint Reconstruction Research Center Tehran University of Medical Sciences  Tehran Iran"},{"name":"Department of Orthopedic Surgery Imam Khomeini Hospital Complex Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pooya","family":"Hosseini\u2010Monfared","sequence":"additional","affiliation":[{"name":"Bone Joint and Related Tissues Research Center Shahid Beheshti University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammadhasan","family":"Kaseb","sequence":"additional","affiliation":[{"name":"Joint Reconstruction Research Center Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,11,18]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm6070063"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21197292"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11033-020-06052-8"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21197292"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00361453"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13018\u2010022\u201003176\u20104"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-199607000-00003"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000022986"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.5312\/wjo.v7.i6.370"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12999"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00434"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/00003086-198604000-00012"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2004.03.003"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.H.00434"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010013\u20102443\u2010x"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00167\u2010015\u20103512\u20100"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.98B1.35692"},{"key":"e_1_2_11_19_1","first-page":"225","article-title":"Morphology 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