Various Surgical Treatment of Hemophilic Pseudotumor : A Case Series

Background: Bleeding episodes in severe hemophilia may occur more frequently and spontaneously after mildtrauma or daily activities. An inadequate treatment of that bleeding in hemophilia may result in pseudotumor,usually in the muscle adjacent to the bone. We reported haemophilic pseudotumor treated with various surgicalinterventions.Methods: This study was conducted inthe Department of Orthopaedic and Traumatology at a government hospitalover a period of 7 years(2010 –2017). Patients Perioperative management was done in accordance with the IntegratedHemophilia Team of our institution protocol.Diagnosis and management planning of hemophilic pseudotumor wasconfirmed via Integrated HemophiliaTeam meeting. After the surgery, all patients were asked to come for routinefollow up.Results: We reported six Haemophilia-A patients with pseudotumor in the pelvis, proximal femur and lowerleg. One case in pelvic bone underwent hematoma evacuation, acetabular reconstruction using the Harringtonprocedure, and total hip arthroplasty.Two cases, a case in the proximal femur and another case in the distal fibula,were treated with amputation, other two cases, one was soft tissue psedotumor in the pelvic region and wastreated by hematoma evacuation, and the remaining casewas managed with wide excision and followed by defectclosure.Conclusion: Surgery is a preferable treatment for pseudotumors that have been present for years.It’s associatedwith the best outcomes especially when selected as the primary line ofwith preventable and manageable bleedingcomplication. As previously published by many authors, this paper confirms that surgical excision is the treatment ofchoice but should only be carried out in major hemophilia centers by a multidisciplinary surgical team.Level of evidence: IV

Keywords:

Hemophilia type-A , Hemophilic pseudotumor , surgical treatment