New house or new limbs

We describe a rare case of end-stage haemophiliac joint disease with inhibitors to factor VIII. Using recombinant factor VIIa treatment, the patient was able to undergo major orthopaedic procedures not previously possible. Although the estimated cost of putting this patient through surgery, prosthetic fitting and rehabilitation is close to £500,000, we hope his overall care requirements will be reduced following the successful surgery and that he will require considerably less in the way of analgesics with an improved independent quality of life for many years.