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Four Residents with Hemophilia of the New Territories Underwent Joint Replacement

16.10.2024

According to the federal quota, the NMRC for Hematology of the Ministry of Health of the Russian Federation, accepted for treatment: a railway worker, a furniture manufacturer, a driver and an accountant from the new territories. These men were united not only by fraternal territories, but also by severe hemophilic arthropathy. 

In the spring of this year, the head of the Department of Traumatology and Reconstructive Orthopedics for Patients with Hemophilia, Doctor of Medical Sciences, Vladimir Yuryevich Zorenko, visited medical institutions of the Donetsk and Lugansk People's Republics as part of a working visit. There, he examined patients diagnosed with hemophilia with severe deforming changes in the articular surfaces. Many of the patients needed high-tech medical care. According to the federal quota, which gives the right to free treatment, the NMRC for Hematology then, almost immediately, accepted a railway worker, a furniture manufacturer, a driver and an accountant for treatment. The men were united not only by fraternal territories, but also by severe hemophilic arthropathy. 

Reference: Arthropathy (from the Greek arthron – joint and páthos – suffering) any pathology of the joints. 

The late stages of arthropathy are accompanied by severe pain , severe deforming changes in the articular surfaces and limited movement, which can lead to disability and a sharp decrease in the quality of life. Endoprosthesis is the only effective method of treatment. 

24-year-old Danil Zakharov came to the NMRC for Hematology from the Lugansk People's Republic. He works as a driver in Alchevsk. Because he was such an active child, he often ended up in hospitals. The target was the same knee. Until 2020, Danil led an active life. He could walk around the city for hours. However, over time, due to joint pain, his physical activity decreased. 

“As of lately, I could only walk from the entrance to the car and back. In the spring, my doctor informed me that a professor was coming to see me. I came to the appointment. Vladimir Zorenko said that I should have an operation.” 

Roman Sankov works as an accountant. His joint problems began in his early teens. Both injuries and factor deficiency were the cause of his joint problems. 

“The news that I could undergo surgery and make my life easier made me very happy. Lately, movement, especially if it is more than normal, is always accompanied by pain. Sometimes, I have to use a cane. Of course, I did have some anxiety about the operation. I was afraid that suddenly something would go wrong. I had never had surgery before. I finally made a decision after I found out that my friend had an operation at the NMRC for Hematology. I really hope that I will be able to realize my dream of seeing the world.” 

Alexander Bogdanov, 48, lives in Ilovaisk with his wife and two sons. For many years, he worked as a communications mechanic of the automatic telephone exchange on the railway. Like many of his wardmates, joint problems began in his teens. The first hip surgery for a then 13-year-old boy, and a citizen of the Soviet Union, was personally performed by Professor Yuri Andreev. 

“Here, they helped me save my left leg after an unsuccessfully healed fracture. And now, 35 years later, I came to the NMRC for Hematology to save my right leg. My joint started to deteriorate. I've been feeling it especially acutely for the last three years. I knew that if I dragged this out, then it would only get worse. And with age, the recovery process is more difficult. When I was offered the opportunity to receive medical care here, I was very happy.”  

Sergey Boyko has been making custom furniture for almost 20 years. At first, he only made furniture for himself, but then orders started coming in. 

“I like my job. Moreover, there are few places where you can get a job with a disability. Factor replacement therapy appeared relatively recently and for me, by the age of 47. Of course, constant bleeding had a significant impact on health. My joints started to hurt 15 years ago. There was no question of an operation. Firstly, this was due to the lack of a blood clotting factor, and secondly, the quota for endoprosthetics had a queue of more than one year. I learned from a friend with hemophilia that he had a very good operation in Moscow. And coincidentally, the head of the department himself came to us, where a friend had a joint replaced. After the professor examined me, he told me to gather all the necessary paperwork. After a while, I was invited for the operation.” 

Sergey's right knee joint, which was operated on by doctors, was fixed in the “extended” position for a long time. 

Orthopedic traumatologist of the Department of Traumatology and Reconstructive Orthopedics for Patients with Hemophilia, Georgy Mishin

“Sergey walked with a straight leg for a long time. The tangential mobility was no more than 10 degrees. A few days after the endoprosthesis, the mobility of the knee joint increased by 40%. Further development of the operated joint is being carried out. The expected mobility is 180 - 90 degrees, which will allow the patient to lead a full life. Performing surgery, on large joints, in patients with hemophilia, is always associated with the risk of serious complications. The treatment of such patients requires an individual approach both in ensuring hemostasis and in prescribing preventive antibacterial therapy. Thanks to the extensive experience of working with such patients, these techniques have already been well developed and widely used at the NMRC for Hematology.” 

After the operation, rehabilitation work is carried out with patients with the help of physical therapists. The “working” of the new joints is carried out on simulators. A special device “ARTROMOT” helps in the development of joints, helping to increase the amplitude of movements. 

As a rule, after knee surgery, patients use crutches for 1 -1.5 months and then a cane for another 1.5 months. After about three months, patients no longer need additional support and walk on their own. However, some patients require continued staged orthopedic treatment due to damage in other joints.

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