Subjective results of joint lavage and viscosupplementation in hemophilic arthropathy

• Published in: Acta ortopedica brasileira Vol. 23; no. 3; pp. 162 - 166
• Main Authors: de Rezende, Márcia Uchoa, Rosa, Thiago Bittencourt Carvalho, Pasqualin, Thiago, Frucchi, Renato, Okazaki, Erica, Villaça, Paula Ribeiro
• Format: Journal Article
• Language: English
• Published: Brazil Sociedade Brasileira de Ortopedia e Traumatologia 01.06.2015; ATHA EDITORA
• Subjects: Hemophilia; Hyaluronic acid/administration & dosage; Hyaluronic acid/therapeutic use; Original; ORTHOPEDICS; Osteoarthritis, knee; Osteoarthritis, knee; Hyaluronic acid/administration & dosage; Hyaluronic acid/therapeutic use; Hemophilia
• ISSN: 1413-7852; 1809-4406; 1413-7852; 1809-4406
• DOI: 10.1590/1413-785220152302145885

To assess whether joint lavage, viscosupplementation and triamcinolone improve joint pain, function and quality of life in patients with severe hemophilic arthropathy. Fourteen patients with knee and/or ankle hemophilic arthritis with and without involvement of other joints underwent joint lavage and subsequent injection of hylan G-F20 and triamcinolone in all affected joints. The patients answered algo-functional questionnaires (Lequesne and WOMAC), visual analog scale for pain (VAS) and SF-36 preoperatively, and at one, three, six and twelve months postoperatively. Sixteen knees, 15 ankles, 8 elbows and one shoulder were treated in 14 patients. Six patients had musculoskeletal bleeding [ankle (1), leg muscle (2) and knees (4)] at 3 months affecting the results. Pain did not improve significantly. Function improved (WOMAC p=0.02 and Lequesne p=0.01). The physical component of SF-36 improved at all time points except at 3 months, with best results at one-year follow-up (baseline = 33.4; 1 month = 39.6; 3 months= 37.6; 6 months 39.6 and 1 year = 44.6; p < 0.001). Joint lavage followed by injection of triamcinolone and hylan G-F20 improves function and quality of life progressively up to a year, even in severe hemophilic arthropathy. Level of Evidence IV, Case Series.