Hemophilic Arthropathy in the Home Care Setting

Thirty-four severe and moderately severe hemophiliacs on a formal comprehensive self-therapy program were prospectively evaluated as to the presence of hemophilic arthropathy, and as to progression or regression of arthropathy over a two-year period. Significant baseline deficits were noted in: flexion and extension of the knee (43 and 25 percent of joints, respectively), dorsiflexion and plantar flexion of the ankle (62 and 81 percent), and flexion and extension of the elbow (74 and 47 percent). Abnormalities of the hips and shoulders were unexpectedly common. In spite of the early and intensive use of plasma products and conservative supportive measures, there was considerable progression of arthropathy during the study period, especially in the older patients, and in patients with significant baseline arthropathy. These data indicate the need for continued aggressive management of arthropathy in patients on home care programs.