Skeletal complications in patients with hemophilia: a single-center experience

Abstract

Background Arthropathy is a common complication in patients with hemophilia. We examined the prevalence of this skeletal complication in patients with hemophilia who were registered at a Comprehensive Hemophilia Center in Shiraz, Southern Iran. Materials and Methods In this cross-sectional study, an orthopedic specialist visited 448 patients and conducted screenings for skeletal complications. The assessment included evaluating the type of hemophilia, disease severity, treatment modality, the presence of inhibitors, and the identification of skeletal complications. Results Ninety patients with hemophilia A, with a mean age (SD) of 31.6 (14.4) years, and 10 patients with hemophilia B, with a mean age of 30.5 (20.6) years, were assessed. The most frequently affected joints were the knee and ankle joints. In the univariate analysis, patients with severe disease were more likely to exhibit synovitis, a target joint, and bone disease compared to patients with non-severe disease. Additionally, a history of treated or active hepatitis and an annual bleeding rate showed significant associations with the target joint. In the multivariable logistic regression analysis, disease severity (OR 14.43, 95% CI 1.6–129.6) and a higher age at diagnosis (OR 1.06, 95% CI 1.00–1.13) increased the likelihood of developing osteoporosis. A history of hepatitis (OR 3.67, 95% CI 1.28–10.48) was identified as an independent risk factor for the target joint. Conclusion Skeletal complications are a common occurrence in hemophilia. Regular consultations with orthopedic specialists, focusing on bleeding control and hepatitis prevention, are essential for reducing the impact of this debilitating complication.

Morphological analysis of patellofemoral joint in haemophilic arthropathy: A case‐control study

“…Whilst other joints such as the shoulder, elbow, hip and ankle may also be affected during the progression of the disease, the knee stands out as the joint most commonly prone to bleeding. 4,5 Whilst the prevalence of severely damaged knees associated with haemophilic arthropathy has shown a decreasing trend in recent decades, particularly with the widespread adoption of prophylactic factor treatments, knee pathologies remain a significant concern for patients with haemophilia (PwH). [6][7][8] It is recognised that knees affected by haemophilic arthropathy exhibit distinct differences in both bone morphology and soft tissue behaviour when compared to normal, healthy knees, as well as knees affected by gonarthrosis.…”