Intraarticular bleeding in children with hemophilia: the prevention of arthropathy.
The treatment of about 400 hemorrhages in the joints of 46 children with hemophilia A are described. The procedures varied according to the location and seriousness of the bleeding and the level of the clotting factor. We always transfused just enough cryoprecipitate to obtain a hemostatic level of factor VIII. When necessary, we would remove blood from the joint. Physical therapy was instituted. The average follow-up period after the initial intra-articular bleeding was 15 years. In patients with a severe form of hemophilia, only 24% of the affected knee joints were in stages III, IV, or V of arthropathy, which should be regarded as a positive result of treatment. We confirmed advanced arthropathy in 21% of the affected elbow joints. Arthropathy occurred only rarely in ankle joints. These results compare favorably to the results obtained among patients undergoing preventative infusions of factor VIII at home.
Gregosiewicz
A
A
Pediatric Orthopaedic Clinic, Lublin, Poland.
Wośko
I
I
Kandzierski
G
G
D002675:Child, Preschool; D005164:Factor IX / Q000627:therapeutic use; D005169:Factor VIII / Q000627:therapeutic use; D005340:Fibrinogen / Q000627:therapeutic use; D005353:Fibronectins / Q000627:therapeutic use; D005500:Follow-Up Studies; D006395:Hemarthrosis / Q000209:etiology* / Q000534:rehabilitation / Q000628:therapy; D006467:Hemophilia A / Q000150:complications* / Q000628:therapy; D002836:Hemophilia B / Q000150:complications* / Q000628:therapy; D006801:Humans; D007592:Joint Diseases / Q000517:prevention & control*; D008297:Male; D026741:Physical Therapy Modalities; D013396:Suction
D005353:Fibronectins; C026912:cryoprecipitate coagulum; D005169:Factor VIII; D005164:Factor IX; D005340:Fibrinogen