Your sister should coordinate her care with surgeon and Hemophilia Treatment Center closest to her. It may be wise to consider factor replacement therapy or at very leat Stimate.

I only had a minor knee surgery but the results were not good. At the time they didn’t acknowledge I was a systematic carrier and the results are a permanent super sized right knee. Surgery was eight years ago.

Surgery went well. Assay done pre-op had factor levels at 69%. Surgery was carried out without any additional factor. We had on stand-by just in case!
Recovery was good and she was driving a stick shift after 4 weeks

I am a carrier and have factor VIII levels in the low 40%. I had to have Helixate prior to minor surgery and DDAVP after. I would imaging a knee replacement would require factor before and after, possibly during recovery/rehab as well.

Ask her to talk to an hematologist, im a hemophilia A severe and im getting surgery in my ankle in about a month and my hematologist will be following me through the process.