{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:54:58Z","timestamp":1790571298601,"version":"4.1.0"},"reference-count":25,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"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>This study aimed to evaluate the clinical and radiographic outcomes of total knee arthroplasty (TKA) in patients with haemophilia A and severely stiff knees (preoperative flexion range of motion \u226440\u00b0) with a focus on functional recovery, implant stability, and complication rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Twenty\u2010four patients (31 knees) with severe haemophilia A and severely stiff knees (mean age: 38.4 years; range: 24\u201361 years) underwent TKA using the medial parapatellar approach and Posterior Stabilised prostheses. Knee ROM and flexion contracture were assessed preoperatively and at the latest follow\u2010up. Radiographic analysis evaluated component stability, joint alignment, deformity correction, and postoperative complications. Long\u2010term implant survivorship was assessed using Kaplan\u2010Meier analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over an average follow\u2010up of 7.2 years (range: 3.2\u201314.8 years), no cases of prosthetic loosening, instability, or axial deformity were found except in two knees. Complications occurred in three patients (9.7%): one late periprosthetic joint infection requiring revision, one superficial wound infection resolved conservatively, and one aseptic loosening requiring revision. Knee flexion improved from 42.8\u00b0 to 81.3\u00b0 and flexion contracture from 16.2\u00b0 to 5.8\u00b0 (both p &lt; 0.001). Ten\u2010year implant survivorship was 93.4% (95% CI: 86.1\u201397.2%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>TKA appears to be a safe and effective intervention for haemophilia patients with severely stiff knees, offering substantial functional recovery, enhanced joint mobility, and a low complication profile. Earlier intervention in patients with flexion &gt;30\u00b0 may optimise outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.70179","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T16:50:06Z","timestamp":1764348606000},"page":"264-271","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Total Knee Arthroplasty in Severe Hemophilic Arthropathy With Stiff Knees(Preoperative Flexion Range of Motion \u226440\u00b0): Functional Outcomes and Long\u2010Term Survivorship"],"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":"Davood","family":"Dehghani Ashkzari","sequence":"additional","affiliation":[{"name":"Trauma Research Center Shahid Sadoughi University of Medical Sciences  Yazd Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani","family":"Azizikia","sequence":"additional","affiliation":[{"name":"Student Research Committee School of Medicine Shahroud University of Medical Sciences  Shahroud Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad","family":"Ayati Firoozabadi","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"}]}],"member":"311","published-online":{"date-parts":[[2025,11,28]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1111\/jth.15444"},{"issue":"11","key":"e_1_2_12_3_1","first-page":"830","article-title":"Primary Total Knee Arthroplasty in Hemophilic Arthropathy","volume":"8","author":"Beckers G.","year":"2023","journal-title":"European Federation of National Associations of Orthopaedics and Traumatology Open Reviews"},{"issue":"2","key":"e_1_2_12_4_1","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":"Journal of Bone and Joint Surgery Open Access"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2021.10.015"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm13082447"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2021.10.015"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2516.2011.02695.x"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0883-5403(89)80046-4"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1054\/arth.2002.32450"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.1014844"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/mr\/roac067"},{"issue":"4","key":"e_1_2_12_13_1","first-page":"470","article-title":"Total Knee Arthroplasty in Patients With Hemophilia: What Do We Know?","volume":"8","author":"Mortazavi S. J.","year":"2020","journal-title":"Archives of Bone and Joint Surgery"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.05.062"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1080\/17474086.2022.2030218"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12832"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.13224"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2019.05.062"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2005.01.008"},{"issue":"3","key":"e_1_2_12_20_1","first-page":"287","article-title":"Hemophilic Arthropathy. Current Concepts of Pathogenesis and Management","volume":"59","author":"Arnold W. D.","year":"1977","journal-title":"Journal of Bone and Joint Surgery American"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-018-2080-0"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.1097\/CM9.0000000000002677"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2022.1014844"},{"key":"e_1_2_12_24_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm11216244"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.1533\/9781782420385.2.69"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12891-022-05535-y"}],"container-title":["Haemophilia"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hae.70179","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/hae.70179","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/hae.70179","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T03:55:50Z","timestamp":1790567750000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/hae.70179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,28]]},"references-count":25,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1111\/hae.70179"],"URL":"https:\/\/doi.org\/10.1111\/hae.70179","archive":["Portico"],"relation":{},"ISSN":["1351-8216","1365-2516"],"issn-type":[{"value":"1351-8216","type":"print"},{"value":"1365-2516","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,11,28]]},"assertion":[{"value":"2025-09-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}