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The target joint.

K Mulder1, A Llinás

  • 1Physiotherapy, Child Health, and Bleeding Disorders Clinic, Health Sciences Center, Winnipeg, Canada. kmulder@hsc.mb.ca

Haemophilia : the Official Journal of the World Federation of Hemophilia
|October 14, 2004
PubMed
Summary

Target joints in severe hemophilia (a bleeding disorder) often lead to permanent joint damage and osteoarthritis. Early, comprehensive treatment, including factor concentrate prophylaxis and physiotherapy, is crucial to prevent irreversible changes, especially in young patients.

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Area of Science:

  • Orthopedics
  • Hematology
  • Pediatrics

Background:

  • Recurrent joint bleeding, known as target joints, is a primary complication in severe hemophilia.
  • This condition leads to progressive joint damage, loss of function, and eventually osteoarthritis.
  • Target joints pose significant challenges, particularly in young children due to susceptible articular cartilage.

Purpose of the Study:

  • To highlight the challenges associated with target joints in hemophilia patients.
  • To emphasize the need for early and comprehensive treatment strategies.
  • To discuss the role of synovectomy in managing persistent synovitis.

Main Methods:

  • Review of clinical manifestations and treatment outcomes for target joints in hemophilia.
  • Analysis of the impact of recurrent bleeding on joint structure and function.

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  • Evaluation of conservative (prophylaxis, physiotherapy) and surgical (synovectomy) interventions.
  • Main Results:

    • Target joints result in irreversible joint damage, including loss of range of motion and muscle strength.
    • Early intervention with factor concentrate prophylaxis and physiotherapy can help resolve synovitis and prevent new bleeds.
    • Synovectomy is recommended for persistent synovitis, though challenging in pediatric cases.

    Conclusions:

    • Urgent and comprehensive treatment is vital to prevent permanent damage in target joints, especially in young hemophilia patients.
    • Factor concentrate prophylaxis and physiotherapy are key to managing synovitis and preventing bleeds.
    • Addressing target ankle joints in very young children requires tailored approaches due to cartilage susceptibility and treatment compliance issues.