Author(s): Dr. Vinay N and Dr. Santhosha JB

Abstract: A major complication in patients with haemophilia is joint damage associated with recurrent intra-articular bleeds. Frequent haemarthrosis affecting target joints can culminate in irreversible, disabling arthropathy, impeding quality of life (QoL)⁴. Despite the availability of on-demand treatment with Factor (F) VIII or IX to manage acute bleeding episodes, haemarthrosis may occur when treatment for bleeding is not effected rapidly, or may proceed without detection. In both instances unchecked bleeding initiates a sequence of events leading to destruction of joint cartilage. The examination include following joints: hip, knee, ankle, shoulder, elbow and wrist. The gross configuration was studied and any deformity (valgus, varus, subluxation, rotation defect), increase in breadth of epiphyses, capsular thickening or muscular atrophy was noted. The range of passive motion of the joints was measured. Loss of range of motion was estimated, when possible, by comparison with the mobility of the contralateral joint. Minor surgery was more common in younger patients. The majority of surgeries in patients ≤5 years and 6–10 years were minor (72.7% [n=8/11] and 64.7% [n=22/34], respectively) and the majority of surgeries in patients aged 11–20 years and 21–30 years were Group 1 major surgery (62.7% [n=106/169] and 55.2% [101/183]). However, Group 1 major surgery was still recommended in 27.3% of patients aged ≤5 years and in 35.3% of patients aged 6–10 years. Also, 10.1% of patients aged 11– 20 years and 15.8% of patients aged 21–30 years were undergoing Group 2 major surgery.

DOI: https://doi.org/10.33545/orthor.2019.v3.i3b.161