How is chronic hemophilic arthropathy treated

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.

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