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Proper IV self-infusion may reduce infection risk in patients with hemophilia
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Educating patients with hemophilia on the proper use of IV self-infusion may significantly reduce the risk of periprosthetic joint infection after joint replacement, according to results presented at the World Federation of Hemophilia Annual Meeting.
In 2005, James Luck, MD, of the Orthopaedic Institute for Children, and colleagues started a protocol to educate patients with hemophilia on a sterile technique for IV self-infusion, emphasizing the high risk of late infection that may be related to IV self-infusion.
“Based on our experience and observations, we postulated that the primary risk factor was tied to frequent intravenous self-infusion,” Luck said in a press release. “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.”
Among 32 patients with hemophilia who underwent 49 primary joint replacements since the protocol was put in place, Luck noted a drop in the rate of primary hematogenous infections from 17% in a previous study to 0% in the current study.
“There were two secondary infections in the current study: one in a patient who developed an infected elbow that spread to his [total knee replacement] TKR and another who fell and sustained a laceration communicating with his TKR,” Luck told Healio.com/Orthopedics. “One was HIV positive and the other HIV negative.”
Luck added the adoption of this protocol at more hemophilia treatment centers may help confirm the findings.
“The next step is for more [hemophilia treatment centers] HTCs to adopt this protocol of patient instruction to see if their rate of late infection of prosthetic joints drops as much as ours,” Luck said. – by Casey Tingle
References:
Luck J, et al. Prevention of late prosthetic joint infection in patients with hemophilia. Presented at: World Federation of Hemophilia Annual Meeting; May 20-24, 2018; Glasgow, United Kingdom.
Disclosure: Luck reports no relevant financial disclosures.