Musculoskeletal Aspects of Haemophilia.

Luck, James V. Jr, MD

Journal of Bone & Joint Surgery - American Volume:
Book Reviews
Author Information

Department of Orthopaedics, University of California at Los Angeles School of Medicine, Los Angeles, California

E.C. Rodriguez-Merchan, N.J. Goddard, and C.A. Lee, editors. Oxford, United Kingdom: Blackwell Science; 2000. 236 pages. $159.00.

This hardbound text is the most comprehensive work to date on musculoskeletal disease and its management in patients with hemophilia. With the exception of a brief description of the diagnosis and management of inherited bleeding disorders, the entire text is devoted to the management of musculoskeletal problems, and it covers the full gamut seen in a comprehensive hemophilia center. Most chapters contain a good description of the literature to date as well as the authors’ experience and current recommendations. The text is well illustrated, but not excessively so. The material is well referenced.

The authors recommend a very cautious and conservative approach to surgery, especially total knee replacement, in patients who are positive for the human immunodeficiency virus. This approach is probably more conservative than that used at many centers in the United States as a result of improved medical management of these patients.

The four chapters dealing with hemophilic pseudotumors are especially comprehensive. Nonoperative management is also well covered, with the possible exception of radiosynovectomy. The chapter on the safety of this procedure is excellent, but the overall discussion of the topic is limited given its wide utilization currently in the United States.

There is a unique and particularly valuable chapter on patient education for musculoskeletal care and preparation for joint replacement that presents the authors’ discussion guidelines and protocol in detail.

The importance of caring for patients with hemophilia at multidisciplinary hemophilia centers is emphasized.

In summary, this text is highly recommended for orthopaedic surgeons as well as physiotherapists, hematologists, hemophilia nurses, and other members of a treatment-center team. Although some sections are controversial, the material is thoughtfully presented.

Copyright 2001 by The Journal of Bone and Joint Surgery, Incorporated