Your bones and joints wear as you age. Target joints can develop advanced arthropathy (joint desease). This is most common in persons with severe hemophilia. Over time, changes may occur that don’t resolve with standard management. The synovium (the tissue that lines a joint and produces a lubricating fluid) remains thickened. The joint feels spongy to the touch; it may have a limitation in range, and it may be painful. Options include:
- Secondary prophylaxis, exercise, bracing, or splinting
- Synovectomy (surgical or chemical removal of the synovium)
- Corticosteroids
Surgery may be necessary to maximize function. The most common procedure for chronic arthropathy is total joint replacement. Surgery is coordinated with the hemophilia treatment center team to manage factor therapy before and after. Protocols for replacement of clotting factor after surgery vary by the type of procedure and the doctor’s judgment.
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