25. Initial and Advanced Stages of Hemophilic Arthropathy, and Other Musculo-Skeletal Problems: The Role of Orthopedic Surgery

  1. Emérito-Carlos Rodríguez-Merchán MD, PHD3,4 and
  2. Leonard A. Valentino MD5
  1. Emérito-Carlos Rodríguez-Merchán MD, PHD3,4,
  2. Victor Jimenez-Yuste MD, PHD1,4 and
  3. Nicholas J. Goddard MB, FRCS2

Published Online: 12 MAY 2011

DOI: 10.1002/9781119979401.ch25

Current and Future Issues in Hemophilia Care

Current and Future Issues in Hemophilia Care

How to Cite

Rodríguez-Merchán, E.-C., Jimenez-Yuste, V. and Goddard, N. J. (2011) Initial and Advanced Stages of Hemophilic Arthropathy, and Other Musculo-Skeletal Problems: The Role of Orthopedic Surgery, in Current and Future Issues in Hemophilia Care (eds E.-C. Rodríguez-Merchán and L. A. Valentino), Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781119979401.ch25

Editor Information

  1. 3

    Department of Orthopedic Surgery and Hemophilia Unit, La Paz University Hospital, Spain

  2. 4

    School of Medicine, Autonomous University, Madrid, Spain

  3. 5

    Hemophilia and Thrombophilia Center, Rush University Medical Center, Chicago, IL, USA

Author Information

  1. 1

    Department of Hematology and Hemostasis Unit, La Paz University Hospital, Spain

  2. 2

    Department of Orthopaedic Surgery, Royal Free Hospital, London, UK

  3. 3

    Department of Orthopedic Surgery and Hemophilia Unit, La Paz University Hospital, Spain

  4. 4

    School of Medicine, Autonomous University, Madrid, Spain

Publication History

  1. Published Online: 12 MAY 2011
  2. Published Print: 13 MAY 2011

ISBN Information

Print ISBN: 9780470670576

Online ISBN: 9781119979401

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Keywords:

  • hemophilia;
  • new developments;
  • synovitis;
  • arthropathy;
  • clinical studies;
  • experimental studies;
  • inhibitors;
  • elderly patients

Summary

Primary prophylaxis is paramount to try to avoid the development of haemophilic synovitis and arthropathy. The best treatment for synovitis is radiosynovectomy (rhenium-186 for ankle and elbows, yttrium-90 for knees). With both methods (prohylaxis and radiosynovectomy) we can delay the development of severe hemophilic arthropathy. In the final stages of hemophilic arthropathy in adult patients, a total joint arthroplasty should be indicated especially at the hip and knee. Muscle hematomas can occur in any part of the body. Any muscle hematoma should be monitored and treated long-term with factor coverage to make sure that complete reabsorption has occurred to avoid the risk of the development of a pseudotumor.