How we treat: Venous thromboembolism prevention in haemophilia patients undergoing major orthopaedic surgery

A 39-year-old male with severe haemophilia A underwent total left knee replacement (TKR) because of severe haemophilic arthropathy. The patient received a single bolus dose of recombinant factor VIII (FVIII) 50 IU kg prior to surgery. A second dose of FVIII 25 IU kg was given at the completion of the procedure, and a continuous infusion was started at 4 IU kg h. Daily FVIII levels were monitored, and the infusion was adjusted to maintain FVIII activity of 80–100% for the 3 days of hospitalization. Intraoperatively and throughout the hospitalization, an intermittent pneumatic compression (IPC) device was used for thromboprophylaxis.

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