Current treatment of hemophilic arthropathy

Hilgartner, Margaret W.

doi:10.1097/00008480-200202000-00008

Cited by 74 publications

(61 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The time when a patient begins to bleed into the joints varies but usually occurs before the age of four. Therefore, some centres wait until two to four joint bleeding episodes take place before starting prophylaxis whereas others perform it as soon as the diagnosis is made [4]. As conservative treatment of haemophilic arthropathy, factor replacement, NSAIDs, joint aspiration, immobilisation and physical therapy are used.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic synovectomy in haemophilic arthropathy of the knee

Yoon

Bae

Kim

et al. 2005

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

From January 1996 to January 2001, arthroscopic synovectomies were performed in 28 knees with haemophilic arthropathy. The mean follow-up period was 5 years and 11 months. Six portals (two anterior, two suprapatellar, two posterior) and a posterior trans-septal portal were used in all cases. The average Hospital for Special Surgery (HSS) knee score increased from 56.4 to 71.5 points at the last follow-up. The average frequency of haemarthrosis reduced from five times per month before operation to once per month. The amount of factor replacement decreased from a mean of 4,633 U to 1,505 U. Progression of arthritis was observed radiographically in three cases at the last follow-up. An arthroscopic synovectomy of the knee using appropriate arthroscopic portals is a useful method in treating haemophilic patients as it decreases bleeding episodes, amount of factor replacement and knee pain.Résumé De janvier 1996 à janvier 2001, des synovectomies arthroscopiques ont été exécutées dans 28 genoux avec une arthropathie hémophilique. Le suivi moyen était 5 années et 11 mois. Six abords (deux antérieurs, deux suprarotuliens, deux postérieurs) et un abord trans-septal postér-ieur ont été utilisé dans tous les cas. Le score moyen du genou de l'Hôpital pour Chirurgie Spéciale (HSS) a augmenté de 56,4 à 71,5 points au dernier examen. La fré-quence moyenne d'hémarthrose s'est réduite de cinq fois par mois avant l'opération à une fois par mois aprés. La quantité moyenne de remplacement de facteur a diminué de 4,633 à 1,505 unités. Dans l'évaluation radiographique, la progression de l'arthrite a été observée dans trois cas au dernier suivi. Une synovectomie arthroscopique du genou qui utilise des abords arthroscopiques appropriés est une méthode utile pour traiter les malades hémophiliques, diminuant les épisodes de saignement, la quantité de facteur et les douleurs du genou.

show abstract

Section: Discussionmentioning

confidence: 99%

Arthroscopic synovectomy in haemophilic arthropathy of the knee

Yoon

Bae

Kim

et al. 2005

International Orthopaedics (SICOT)

View full text Add to dashboard Cite

show abstract

“…Joint disease affects 90% of severe haemophiliacs and contributes to most of the morbidity of this condition [1]. Ankles, knees and elbows are the joints most frequently involved [2].…”

Section: Introductionmentioning

confidence: 99%

State‐of‐the‐art imaging techniques for the evaluation of haemophilic arthropathy: present and future

Doria

2010

Haemophilia

102

View full text Add to dashboard Cite

Summary. In spite of the fact that the diagnosis of haemophilia is essentially clinical and laboratorybased, imaging has become an important tool for the evaluation of complications, diagnostic confirmation and/or complementation and therapeutic follow-up in haemophilic arthropathy. Radiography remains the workforce horse in the diagnosis and follow-up of haemophilic arthropathy. The radiographical findings in arthropathy follow an expected sequence of events and are overall similar in different joints. Magnetic resonance imaging (MRI) has advantages over radiography based on its capability of visualizing soft tissue and cartilage changes in haemophilic joints. The recent development and standardization of MRI scoring systems for measuring soft tissue and cartilage abnormalities may enable the comparison of pathological joint findings in clinical trials conducted at different institutions across the world. The implementation of high-frequency transducers and colour/power Doppler capabilities has provided new insights for clinical applications of ultrasonography (US) in haemophilic arthropathy. In spite of the imaging modality's technical challenges such as operator-dependency, US has advantages over MRI. One of these advantages is its ability of differentiating synovium hypertrophy and hemosiderin deposition, which is not possible with MRI given the presence of susceptibility artefacts from extracellular hemosiderin on gradient-echo MR images. In addition to the aforementioned conventional imaging modalities, novel imaging techniques (blood oxygen level dependent, ultrasmall superparamagnetic ironoxide contrast-enhanced, and T1 and T2 mapping MRI, ultrasound biomicroscopy, microbubble contrast-enhanced US and positron emission tomography, among others) hold promise for early assessment of haemophilic arthropathy in the future upon completion of their clinical validation.

show abstract

“…At later stages with pronounced joint contractures, possible treatments include arthrodesis and arthroplasty. For the hip, arthroplasty is the option of choice and remains the best solution [8,11,19].…”

Section: Introductionmentioning

confidence: 99%

Total hip replacement in patients with severe bleeding disorders

Habermann

Eberhardt

Hovy³

et al. 2006

International Orthopaedics (SICO

View full text Add to dashboard Cite

Arthropathy of the hip is moderate in frequency in haemophiliac patients, but is less common than ankle, knee or elbow arthropathy. We report about our experience with total hip replacement in patients with severe bleeding disorders over a period of 30 years. Between July 1972 and 2002, 15 hips in 13 patients were replaced. The main bleeding disorders were Haemophilia A in ten patients and severe v. Willebrand disease in three patients. The mean follow-up was 132 months (range 12-363). We can demonstrate good long-term results, with only one aseptic loosening after 14 years and one septic loosening after 14 months in an HIV-positive patient. The Harris Hip Score increased from 48 points (32-66) preoperatively to 89 (76-100) postoperatively. In conclusion, total hip replacement performed in a specialised haemophiliac centre is a safe procedure, and results in pain relief and improvement of the quality of life in patients with severe bleeding disorders.

show abstract

Current treatment of hemophilic arthropathy

Cited by 74 publications

References 12 publications

Arthroscopic synovectomy in haemophilic arthropathy of the knee

Arthroscopic synovectomy in haemophilic arthropathy of the knee

State‐of‐the‐art imaging techniques for the evaluation of haemophilic arthropathy: present and future

Total hip replacement in patients with severe bleeding disorders

Contact Info

Product

Resources

About