What are the risks and complications of knee surgery in hemophilia?

Question

Hello doctor,

I am planning knee surgery for a torn meniscus. The problem is that I have mild hemophilia A (factor levels around 8%). My orthopedist seems nervous about operating and referred me here. How risky is surgery with my condition? Will I need special treatments before and after? Is the recovery time longer than usual? I am worried about excessive bleeding and other complications. Regular cuts and bruises are not a huge problem for me, usually, but surgery seems different. Is there a special protocol? Should I get a second opinion or find a surgeon who specializes in dealing with patients with bleeding disorders? Kindly give your suggestions on this.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

Surgery with mild hemophilia A (factor VIII approximately 8 %) is manageable but requires careful planning. Your risk of excessive bleeding is higher, but since you do not usually have significant bleeding issues, it is likely controllable with preoperative and postoperative factor VIII replacement therapy or DDAVP (Desmopressin). Hematologists should be involved in developing a perioperative bleeding management plan, including factor level monitoring and possibly antifibrinolytics (like Tranexamic acid) to reduce bleeding risk. Recovery time is not necessarily longer, but complications could delay healing. A surgeon experienced in bleeding disorders is ideal, so a second opinion may be wise. I hope this information helps you.

Thank you.