Breakthrough Study at Orthopaedic Institute for Children Reveals That Education Can Reduce Prosthetic Joint Infections in Hemophilia Patients

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A breakthrough study conducted at the Orthopaedic Institute for Children (OIC) in Los Angeles has revealed that better patient education can significantly reduce the chance of prosthetic joint infection in patients with hemophilia. The findings will be presented at the World Federation of Hemophilia’s annual meeting in Glasgow next month.

Hemophilia is a rare and inherited bleeding disorder in which the blood doesn’t clot normally. It can be a crippling disease with a range of issues causing discomfort and problems for patients, including bleeding in joints or limbs and deformities caused by chronic arthritis. This arthritis begins in childhood and often requires joint replacement by early adulthood to middle age. People with hemophilia often bleed for a longer time than others after an injury. They may also bleed internally, which can damage organs and tissues and may be life-threatening.

Historically, joint replacement infection is much more common in patients with hemophilia than in other forms of arthritis. Many in the medical and scientific communities have believed that this is the result of immune suppression in those with HIV infection. The physicians and researches at OIC weren’t so sure.

“Based on our experience and observations, we postulated that the primary risk factor was tied to frequent intravenous (IV) self-infusion,” said James Luck, M.D., director of surgery and rehabilitation of OIC’s Hemophilia Treatment Center and professor-in-residence at the UCLA/Orthopaedic Institute for Children department of orthopaedic surgery. “We wanted to find out the true cause of this and what could be done to mitigate the occurrence of these infections, which usually require removal of the implant, treatment of the infection, and then reinsertion of the implant. If the infection recurs, it will require more procedures and occasionally even amputation.”

Toward that end, in 2005 OIC’s Hemophilia Treatment Center began a comprehensive program of patient education in the proper use of IV self-infusion for all of its patients who had prosthetic joints. In the subsequent six years, the center performed 49 primary joint replacements in 32 patients with hemophilia. The results of proper IV self-infusion education for these patients were startling.

“Incidents of infection dropped from 17 percent to zero percent for these patients, meaning that there have been no primary infections over this timeframe,” said Dr. Luck. “While immune suppression might still be an aggravating factor, it is clear from our study that the primary source of late infection in patients with hemophilia is frequent IV self-infusion being poorly administered. Through protocol-driven patient education in sterile techniques for IV self-infusion, the incidents of prosthetic joint infection can be significantly impacted.”

For more than 50 years, OIC’s Hemophilia Treatment Center has been at the leading edge of treatment to help patients suffering from hemophilia and bleeding disorders live healthier, happier and pain-free lives. The center pioneered the concept of providing a comprehensive, multidisciplinary team approach to the management of children and adults with bleeding disorders. As a result, the center was designated an International Hemophilia Training Center in 1970 – one of the first four in the world — by the World Federation of Hemophilia. The center’s physicians are at the forefront of their field and are actively involved in hemophilia-based research and treatment.

About Orthopaedic Institute for Children

Orthopaedic Institute for Children (OIC) was founded in 1911 as Los Angeles Orthopaedic Hospital. Focused solely on musculoskeletal conditions in children, OIC receives nearly 70,000 patient visits each year. In alliance with UCLA Health and with the support of the OIC Foundation, we advance pediatric orthopaedics worldwide through outstanding patient care, medical education and research. Our locations in downtown Los Angeles, Santa Monica, Westwood and Calexico treat the full spectrum of pediatric orthopaedic disorders and injuries. For more information, visit us at ortho-institute.org.

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Business Wire: 19:34 GMT Monday 16th April 2018

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