Management of Musculoskeletal Complications in Patients with Hemophilia: Literature Review and Expert Recommendations

In people with hemophilia, hematological prophylaxis during childhood and adolescence could elude the occurrence of musculoskeletal complications (in joints and muscles) if the concentration of the defective factor is averted from decreasing under 1% of normal. Prompt management is of capital significance as the juvenile skeleton is hypersensitive to the adverse events of the disease; intense structural defects might appear rapidly. Important, articular bleeds and inveterate hypertrophy of the articular synovial membrane must be treated vigorously to preclude joint degeneration (hemophilic arthropathy). At the moment that extreme joint disease is in place with intense affliction, the goal must be to reestablish activity whilst at the same time reducing the peril to the patient. Arthroscopic articular debridement is an efficacious surgical technique to accomplish this goal, particularly around the knee or ankle, and maybe contemplated to be a backup to ankle arthrodesis or ankle or knee replacement in patients of younger age. Eventually, joint replacement can commonly reestablish both articular mobility and function in an unhealthy articulation.