Sébastien Lobet

Subclinical deep venous thrombosis observed in 10% of hemophilic patients undergoing major orthopedic surgery

To cite this article: Hermans C, Hammer F, Lobet S, Lambert C. Subclinical deep venous thrombosis observed in 10% of hemophilic patients undergoing major orthopedic surgery. J Thromb Haemost 2010; 8: 1138–40. Deep venous thrombosis (DVT) is a common postoperative complication in patients undergoing major orthopedic surgery of the lower limbs, such as total hip replacement (THR), total knee replacement (TKR) or hip fracture surgery (HFS). In the absence of thromboprophylaxis, subclinical venous thrombosis rates as high as 60% have been reported when using systematic bilateral phlebography after orthopedic surgery. As a result, routine pharmacological thromboprophylaxis with low-molecular-weight heparin (LMWH) or an alternative antithrombotic agent is strongly recommended in patients undergoing these procedures [1]. With the availability of efficient and safe clotting factor concentrates, THR, TKR as well as ankle arthrodesis are frequently performed in subjects with hemophilia suffering from chronic hemophilic arthropathy [2]. Yet, pharmacological prophylaxis of venous thromboembolism (VTE) in this patient group remains controversial. With the exception of retrospective case reports and small series, the incidence of VTE disease in hemophilic patients after major orthopedic surgery is still unclear. Despite the concern that pharmacological thromboprophylaxis might increase bleeding complications in these patients, no properly sized study has objectively evaluated the need, appropriate timing, dosage and duration of low-molecular weight heparin (LMWH) prophylaxis in this

Reliability and clinical features associated with the IPSG MRI tibiotalar and subtalar joint scores in children, adolescents and young adults with haemophilia.

To assess the reliability of the IPSG MRI scale for tibiotalar (TTJ) and subtalar joint (STJ) changes in young haemophilic patients, correlating MRI findings with functional scores and 3D‐rearfoot kinematics.

3D Multi-segment foot kinematics in children: A developmental study in typically developing boys

BACKGROUND The relationship between age and 3D rotations objectivized with multisegment foot models has not been quantified until now. The purpose of this study was therefore to investigate the relationship between age and multi-segment foot kinematics in a cross-sectional database. METHODS Barefoot multi-segment foot kinematics of thirty two typically developing boys, aged 6-20 years, were captured with the Rizzoli Multi-segment Foot Model. One-dimensional statistical parametric mapping linear regression was used to examine the relationship between age and 3D inter-segment rotations of the dominant leg during the full gait cycle. RESULTS Age was significantly correlated with sagittal plane kinematics of the midfoot and the calcaneus-metatarsus inter-segment angle (p<0.0125). Age was also correlated with the transverse plane kinematics of the calcaneus-metatarsus angle (p<0.0001). CONCLUSION Gait labs should consider age related differences and variability if optimal decision making is pursued. It remains unclear if this is of interest for all foot models, however, the current study highlights that this is of particular relevance for foot models which incorporate a separate midfoot segment.

Stop only advising physical activity in adults with haemophilia… prescribe it now! The role of exercise therapy and nutrition in chronic musculoskeletal diseases.

1 Manco-Johnson MJ, Abshire TC, Shapiro AD et al. Prophylaxis versus episodic treatment to prevent joint disease in boys with severe hemophilia. N Engl J Med 2007; 357: 535–44. 2 World Federation of Hemophilia. Guidelines for the management of hemophilia (2nd Edition). Haemophilia 2013; 19: e1–47. 3 Powell JS, Josephson NC, Quon D et al. Safety and prolonged activity of recombinant factor FVIII Fc fusion protein in hemophilia A patients. Blood 2012; 119: 3031–7. 4 Mahlangu J, Powell JS, Ragni MV et al. Phase 3 study of recombinant factor VIIIFc fusion protein in severe hemophilia A. Blood 2014; 123: 317–25. 5 Collins PW, Blanchette VW, Fischer K et al. Break-through bleeding in relation to predicted factor VIII levels in patients receiving prophylactic treatment for severe hemophilia A. JTH 2009; 7: 413–20. 6 Liu T, Hoehn T, Hoehn S, Patarroyo-White S, Pierce G, Jiang H. Evaluation of antibody responses to rFVIIIFc compared to Xyntha and Advate in hemophilia A mice. Haemophilia 2012; 18(Suppl S3): 41. 7 Ragni MV, Alabek M, Malec LM. Inhibitor development in two cousins receiving full-length factor VIII and factor VIII-Fc fusion protein. Haemophilia 2016. doi: 10.1111/hae.13032. 8 De Groot A, Moise L, McMurry JA et al. Activation of natural regulatory T cells by IgG Fc–derived peptide “Tregitopes”. Blood 2008; 112: 3303–11. 9 Hay CR, DiMichele DM; for the International Immune Tolerance Study. The principal results of the International Immune Tolerance Study: a randomized dose comparison. Blood 2012; 119: 1335–44. 10 Miller CH, Platt SJ, Rice AS, Kelly F, Soucie JM; Hemophilia Inhibitor Research Study Investigators. Validation of Nijmegen-Bethesda assay modifications to allow inhibitor measurement during replacement therapy and facilitate inhibitor surveillance. JTH 2012; 10:1055–61.

Postural control during a transition task in haemophilic children, adolescents and young adults with haemophilic ankle arthropathy

The aim of this study was to determine whether young haemophilic boys with and without MRI‐based signs of ankle arthropathy demonstrate reduced balance ability during a transition task with eyes open and eyes closed.

The second Team Haemophilia Education Meeting, 2016, Frankfurt, Germany

The first Team Haemophilia Education (THE) Meeting was held on 7–8 May 2015 in Amsterdam, The Netherlands. It aimed to promote the optimal care of patients with haemophilia through education of the multidisciplinary treatment team. This was achieved by reviewing the latest developments in haemophilia management, considering how these can be implemented in the clinic to improve patient care and providing a platform for networking and debate for all haemophilia treatment team members. The second THE Meeting was held on 19–20 May in Frankfurt, Germany, and participants included doctors, nurses, physiotherapists, patient representatives and data management staff from 20 different countries. Topics covered the role of the multidisciplinary team in delivering the best haemophilia care, challenges in the management of haemophilia across Europe, available clotting factor treatments, future treatments and the use of genetics in advising carriers of haemophilia. This report is a summary of the key developments in haemophilia care presented by various investigators and healthcare professionals at THE Meeting 2016.