title: Treatment of subchondral cysts in patients with haemophilia.
abstract: BACKGROUND
  The haemophilic arthropathy is a disabling disease that causes chronic pain and functional limitation, due to recurrent intra-articular bleeding, with impaired quality of life.
  
  
  OBJECTIVE
  The aim of this work is to present our 24-year experience in the treatment of subchondral cysts filled with hydroxyapatite coralline in patients with haemophilia.
  
  
  METHODS
  Thirty-seven male patients with forty-nine cystic lesions were treated and evaluated between 1990 and 2014. Thirty four patients were haemophilia type A, three were haemophilia type B, two patients had inhibitors to factor VIII. The average age was 23.6 years. The average follow-up was 10 years. The lesions were located: twenty-four in the tibia (49%), six in the talus (12.2%), seven in the ulna (14.4%), five in the humerus (10.2%), five in the femur (10.2%) and two in the distal radius (4%). In all patients' radiographs, Computed Tomography and Magnetic Resonance Imaging were performed before surgery. The lesions were treated when the injury was greater than 15% of the joint area, and when the joint area was greater than 1 cm of diameter. Surgical technique consisted of aspirating the cyst contents and refilling it with hydroxyapatite coralline.
  
  
  RESULTS
  In forty-eight cysts, restitution of bone structure was achieved by impaction of hydroxyapatite coralline. The average time of bone restoration was 10 months. Only one patient required a second intervention.
  
  
  CONCLUSIONS
  The treatment of subchondral cyst in PWH by aspiration and filling with hydroxyapatite coralline allows bone restoration and delays deterioration of the joint treated.
authors.affiliation: Department of Orthopaedic and Traumatology, General Hospital Dr. Juan A. Fernández, Ciudad Autónoma de Buenos Aires, Argentina.|Foundation of Haemophilia, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: H
authors.initials: H
authors.lastname: Caviglia
authors.affiliation: Department of Orthopaedic and Traumatology, General Hospital Dr. Juan A. Fernández, Ciudad Autónoma de Buenos Aires, Argentina.|Foundation of Haemophilia, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: G
authors.initials: G
authors.lastname: Galatro
authors.affiliation: Department of Orthopaedic and Traumatology, General Hospital Dr. Juan A. Fernández, Ciudad Autónoma de Buenos Aires, Argentina.|Foundation of Haemophilia, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: G
authors.initials: G
authors.lastname: Cambiaggi
authors.affiliation: Department of Orthopaedic and Traumatology, General Hospital Dr. Juan A. Fernández, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: M E
authors.initials: ME
authors.lastname: Landro
authors.affiliation: Foundation of Haemophilia, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: M
authors.initials: M
authors.lastname: Candela
authors.affiliation: Foundation of Haemophilia, Ciudad Autónoma de Buenos Aires, Argentina.
authors.forename: D
authors.initials: D
authors.lastname: Neme
keywords: cyst; fibrin; haemophilia; haemophilic arthropathy; hydroxyapatite coralline