{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T04:54:57Z","timestamp":1790571297729,"version":"4.1.0"},"reference-count":26,"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 aims to evaluate the natural course and resolution of flexion contracture following total knee arthroplasty (TKA) in individuals with haemophilic arthropathy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between April 2010 and April 2014, 65 patients with haemophilic arthropathy and preoperative flexion contracture underwent TKA at a single institution. Patients were followed for 56 months (range 48\u201372 months). Range of motion, Knee Society Score, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and SF\u201036 scores were assessed at 3, 6, 12, 24, and 56 months. An intensive physiotherapy protocol included supervised sessions twice weekly for 3 months.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean age was 34.2\u00a0\u00b1\u00a08.3 years. Preoperative flexion contracture of 27.6\u00a0\u00b1\u00a011.2\u00b0 improved to 14.3\u00a0\u00b1\u00a06.2\u00b0 postoperatively, then to 6.9\u00a0\u00b1\u00a03.3\u00b0 at 3 months, 4.4\u00a0\u00b1\u00a02.2\u00b0 at 6 months, 2.2\u00a0\u00b1\u00a03.2\u00b0 at 12 months, and 2.1\u00a0\u00b1\u00a03.1\u00b0 at 56 months (\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). Patients with clinically significant flexion contracture\u00a0&gt;\u00a05\u00b0 decreased from 53 postoperatively (81.5%) to 10 at 3 months (15.4%), 6 at 12 months (9.2%), and 5 at 56 months (7.7%). Multivariate analysis identified immediate postoperative flexion contracture\u00a0&gt;\u00a015\u00b0 (OR 8.3,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002) and age\u00a0&gt;\u00a040 years (OR 4.1,\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.019) as independent predictors of residual contracture\u00a0&gt;\u00a05\u00b0 at final follow\u2010up. Final flexion contracture\u00a0\u2264\u00a05\u00b0 was achieved in 90.8% at 12 months and maintained in 92.3% at 56 months.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Residual flexion contracture after TKA in haemophilic arthropathy demonstrates significant spontaneous improvement, with 92% correction by 12 months, sustained through 56\u2010month follow\u2010up. This pattern contrasts with commonly reported outcomes in osteoarthritic populations. In haemophilic patients with excellent rehabilitation compliance, surgeons can be confident that mild residual contracture is likely to improve over time.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hae.70181","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T16:45:02Z","timestamp":1764348302000},"page":"272-278","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Clinical Course of Residual Flexion Contracture After Total Knee Arthroplasty in Patients With Haemophilic Arthropathy"],"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":"Mohammadhasan","family":"Kaseb","sequence":"additional","affiliation":[{"name":"Joint Reconstruction Research Center Tehran University of Medical Sciences  Tehran Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohmmad","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":"10.1007\/s11420\u2010009\u20109140\u20109"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102516.2004.00899.x"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/1529\u20100131(199905)42:5<1025::AID\u2010ANR23>3.0.CO;2\u20103"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1302\/0301\u2010620X.80B3.0800540"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/hae.12999"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.arth.2006.11.009"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.C.01609"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102516.2010.02308.x"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/art.20284"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102141.2008.07386.x"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2020.00541"},{"issue":"284","key":"e_1_2_12_13_1","first-page":"221","article-title":"The Management of Fixed Flexion Contractures During Total Knee Arthroplasty","author":"Firestone T. 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