Intraarticular management of chronic haemophilic arthropathy (Review)

Poenaru,Daniela; Sandulescu,Miruna Ioana; Cinteza,Delia

doi:10.3892/br.2023.1641

Intraarticular management of chronic haemophilic arthropathy (Review)

Authors:
- Daniela Poenaru
- Miruna Ioana Sandulescu
- Delia Cinteza
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Affiliations: Rehabilitation Department, Carol Davila University of Medicine and Pharmacy, Bucharest 020021, Romania, Doctoral School, Carol Davila University of Medicine and Pharmacy, Bucharest 020021, Romania
Published online on: July 21, 2023 https://doi.org/10.3892/br.2023.1641
Article Number: 59
Copyright: © Poenaru et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

Hemophilia is an inherited X‑linked bleeding condition with predominant joint involvement due to intra‑articular bleeding, hemosiderin deposition and the synovial hypertrophy that is responsible for cartilage destruction, joint deformity and malalignment, pain and functional restriction. Management of chronic arthropathy includes conservative and surgical approaches. Conservative therapies consist of pain modulation, oral drugs, physiotherapy and intra‑articular agents. For the present review, the literature was searched for intra‑articular agents and 20 papers on the use of corticosteroids (CS), hyaluronic acid (HA) and platelet‑rich plasma (PRP), with different regimes of administration, were included. CS had a longer record of injection, with statistically significant pain reduction and functional improvement in the short‑term and moderate persistence in the long‑term. HA was able to improve the clinical and functional status of joints with moderate or severe hemophilia. PRP was relatively recently introduced to joint management and the results remain controversial. Different associations between the above‑mentioned agents were proposed by studies including a small number of patients, producing comparable results. It was concluded that there is a need for extensive research on intra‑articular agents, with stratification according to the severity of joint involvement. The lack of a blinded or placebo‑controlled arm due to ethical aspects makes the task challenging.

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