{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T05:05:16Z","timestamp":1784005516438,"version":"3.55.0"},"reference-count":22,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T00:00:00Z","timestamp":1783987200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study aimed to compare the perioperative bleeding risk and economic outcomes of pharmacokinetic (PK)-guided versus weight-guided coagulation factor replacement regimens during the perioperative period for patients with hemophilia undergoing joint arthroplasty.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Method<\/jats:title>\n                    <jats:p>We conducted a retrospective analysis of clinical data from patients with hemophilia who underwent knee or hip joint arthroplasty at our center between 2013 and 2025.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty-three male patients with a median age of 39\u202fyears were included. Twenty-five patients (75.8%) had severe hemophilia. Seventeen patients (51.5%) underwent total joint arthroplasty, and 16 (48.5%) underwent partial joint arthroplasty. Perioperative coagulation factor replacement was weight-guided in 22 patients (66.7%) and PK-guided in 11 patients (33.3%). Postoperative SF-6Dv2 scores indicated a significant improvement in quality of life compared to preoperative baselines. The PK-guided group demonstrated a significantly lower median hospitalization cost (138,232 RMB vs. 200,122 RMB,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0073) and lower median coagulation factor consumption (701.6\u202fIU\/kg vs. 892.9\u202fIU\/kg,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.0304) compared to the weight-guided group. Median intraoperative blood loss and perioperative hemoglobin decrease were comparable between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>For patients with hemophilia undergoing joint arthroplasty, a PK-guided coagulation factor infusion regimen significantly reduced factor consumption and overall medical costs, without a statistically significant increase in perioperative bleeding risk compared with the weight-guided approach. These exploratory findings support the clinical and economic advantages of PK-guided management in this surgical setting and warrant confirmation in larger, prospective studies.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1863312","type":"journal-article","created":{"date-parts":[[2026,7,14]],"date-time":"2026-07-14T04:22:34Z","timestamp":1784002954000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacokinetic-guided versus weight-guided coagulation factor replacement in hemophilia patients undergoing arthroplasty: a retrospective real-world study on perioperative bleeding risk and economic outcomes"],"prefix":"10.3389","volume":"13","author":[{"given":"Shuxia","family":"Zhang","sequence":"first","affiliation":[{"name":"Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Chen","sequence":"additional","affiliation":[{"name":"Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haojie","family":"Qin","sequence":"additional","affiliation":[{"name":"Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Chen","sequence":"additional","affiliation":[{"name":"Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunrong","family":"Chen","sequence":"additional","affiliation":[{"name":"Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xuemei","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Fujian Medical University Union Hospital","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic, Fujian Medical University Union Hospital","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiajun","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Orthopedic, Fujian Medical University Union Hospital","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fenge","family":"Yang","sequence":"additional","affiliation":[{"name":"Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meijuan","family":"Huang","sequence":"additional","affiliation":[{"name":"Fujian Provincial Key Laboratory on Hematology, Fujian Medical University Union Hospital, Fujian Institute of Hematology","place":["Fuzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,14]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"192","DOI":"10.1016\/j.phrs.2016.11.032","article-title":"Pathophysiology of hemophilic arthropathy and potential targets for therapy","volume":"115","author":"Pulles","year":"2017","journal-title":"Pharmacol Res"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"63","DOI":"10.3390\/jcm6070063","article-title":"Pathophysiology of Hemophilic 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