Hemophilic pseudotumor gradually erodes bone and induces fracture or deformity, 
causing joint dysfunction or destructive osteoarthropathy. Reports about surgery 
for hemophilic pseudotumor complicated by destructive osteoarthropathy are 
scarce. The object of this study was to evaluate the results and complications 
of surgical management for patients of pseudotumor complicated by destructive 
osteoarthropathy. We retrospectively reviewed records from July 1996 to July 
2013, and found eight patients with pseudotumor complicated by destructive 
osteoarthropathy. We recorded their demographic data, time of surgery, amount of 
blood loss and transfusion, bone union, and complications. Seven patients were 
diagnosed with hemophilia A and one with hemophilia B. The mean age at surgery 
was 31.9 ± 8.3 years. Two of the eight underwent excision of the pseudotumor and 
metallic fixation, one had amputation, and five underwent autogenous or 
exogenous bone grafting and fixation with an absorbable screw. The median 
operating time was 170 min (135-315 min). The median amount of intraoperative 
blood loss was 1350 ml (100-4000 ml). The amount of red blood cells, plasma, and 
whole blood transfusion after surgery were 0-24 units, 0-2000 ml, and 0-4600 ml, 
respectively. After a median follow-up of 75 months, the numbers of pseudotumor 
recurrence, fracture nonunion, coagulation factor inhibitor formation, and wound 
complications were one, one, two, and four, respectively. Surgery is an 
effective treatment for hemophilic pseudotumor complicated by destructive 
osteoarthropathy. However, the incidences of wound infection, coagulation factor 
inhibitor formation, hemophilic pseudotumor recurrence, and fracture nonunion 
are high.