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Patient | Type and severity | Inhibitor | Duration until amputation | Daily factor replacement | Initial diagnosis of HO | Management before amputation | Direct reason for amputation | Amputation procedure | Outcome |
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1 | A, severe | Yes, active (6.8 ⟶ 1.9 BU/ml) | 21 years | Regular replacement as secondary prophylaxis (FVIII 20,000 IU per year) | Hemophilic arthritis of both hip and knee | Bilateral THA | Hemophilic pseudotumor with large bone defects (following periprosthetic fracture) | Disarticulation of left hip, right TKA | Left hip wound unhealing, received debridement three times. The wound healed after 6 months’ dressing, walking with crutches (3 years after amputation) |
2 | A, severe | No | 17 years | Inadequate secondary prophylaxis. (irregular FVIII injection on demand) | Pathological fracture of right femur | Bone traction of right femoral fracture | Pathological fracture, internal fixation failure, hemophilic pseudotumor with infection | Above-knee amputation of right side | No complication, walking with crutches (3 years) |
3 | A, moderate | No | Since childhood (26 years) | Regular primary prophylaxis (FVIII approx. 5,000 IU per year) | Hemophilic arthritis with chronic osteomyelitis on right knee | Debridement of right knee ulcerative wounds | Knee stiffness with chronic osteomyelitis | Above-knee amputation of right side | No complication, walking with crutches (1 year) |
4 | A, moderate | No | Since childhood (24 years) | Regular primary prophylaxis (FVIII injection) | Hemophilic pseudotumor of right thigh, with systematic infection | N/A | Hemophilic pseudotumor with systematic infection | High-thigh amputation of right side | Transferred to ICU for 3 days after the operation, no postoperative complication; died from epilepsy two years after amputation |
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