Hemophilic Arthropathy

Abstract

Key Points The most common rheumatologic complication in severe hemophilia is hemophilic arthropathy, which mainly affects the elbows, knees, and ankles. A combined cascade of degenerative and inflammatory processes initiated by recurrent joint bleeds leads to hemophilic arthropathy. Other musculoskeletal complications of hemophilia are muscle and soft tissue hemorrhage, chronic synovitis resulting from the inflammatory processes, pseudotumors, and osteoporosis. Treatment aims at prevention of recurrent hemarthrosis through prophylactic factor replacement therapy. If conservative measures fail, orthopedic surgery, including total joint replacement, is indicated and can be performed safely with clotting factor replacement therapy.