What's on this Page
How is chronic hemophilic arthropathy treated
The treatment principles for chronic hemophilic arthropathy are outlined in the below table
Treatment Principles for Chronic Hemophilic Arthropathy
| Prophylactic infusions of factor VIII to prevent recurrences of hemarthrosis (factor goal >5%) |
| Non-weight-bearing rest periods to allow synovitis to regress |
| Physical therapy to improve joint stability and maintain muscle strength |
| Intraarticular glucocorticoids to reduce symptoms and recurrent hemarthroses |
| Nonacetylated salicylates or cox-2 specific inhibitors (celecoxib) for pain and swelling |
| Arthroscopic synovectomy for chronic synovitis unresponsive to conservative therapy |
| Total joint arthroplasty for end stage joint disease |
| Consider rifampicin chemical synoviorthesis (particularly small joints) |
| Consider radioisotope synovectomy (particularly if factor inhibitor present) with P32 or 90-yttrium |
| Systemic and/or local anticytokine therapies are being evaluated |
Treatment programs must be individualized for each patient. Difficult patients are frequently referred to specialized treatment centers.
