Joint surgery in von Willebrand disease: a multicentre cross-sectional study

K. P.M. van Galen*, K. Meijer, H. C. Vogely, J. Eikenboom, R. E.G. Schutgens, M. H. Cnossen, K. Fijnvandraat, J. G. van der Bom, B. A.P. Laros-van Gorkom, F. W.G. Leebeek, E. P. Mauser-Bunschoten,

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

2 Citations (Scopus)


BACKGROUND: Joint bleeds are reported by 23% of von Willebrand disease (VWD) patients and associated with orthopaedic surgery. Limited data are available on joint surgery in VWD.

AIM: To assess the prevalence, indications, management and complications of joint surgery in VWD patients.

METHODS: 804 VWD patients with historically lowest von Willebrand factor (VWF) activity ≤30 U dL(-1) completed a questionnaire on joint bleeds, joint damage and orthopaedic surgery. We retrieved additional medical file data of patients who underwent surgery on large joints (shoulder, elbow, hip, knee or ankle).

RESULTS: 116 out of 804 patients (14%) reported large joint surgery. Compared to VWD patients without previous orthopaedic surgery, these 116 patients reported more frequently a history of joint bleeds and joint damage (41% vs. 20%, P < 0.001 and 61% vs. 20%, P < 0.001). Medical file data on 126 large joint surgeries in 79 VWD patients revealed that this surgery was associated with joint damage due to prior joint bleeds in 24% of the procedures. Preoperative clotting factor correction (CFC) to prevent bleeding was administered in most cases (81%). Documentation on postoperative bleeding was found in 23 surgeries (18%).

CONCLUSIONS: Large joint surgery is reported by 14% of VWD patients, related to joint bleeds in 24% and seems associated with bleeding complications frequently despite perioperative CFC.

Original languageEnglish
Pages (from-to) 256–262
Number of pages7
Issue number2
Publication statusPublished - Mar 2016


  • Arthropathy
  • Joint bleeds
  • Orthopaedic surgery
  • Von Willebrand disease


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