Rehabilitation of synovitis in patients with haemophilia

Monitoring the synovium is a central requirement in haemophilia. In cases of acute synovitis, a sufficiently high dosage of coagulation factor should be used immediately, and pain control and anti-inflammatory treatment are essential. Severe effusion should be aspirated and persistent inflammation should be treated with steroid injections. In relation to physical therapy, cryotherapy with CO(2), and CP current after Bernhard should be used, if appropriate in combination with ultrasound and phonophoresis with Voltaren [Voltarol] Emulgel. Early functional treatment is essential following a short individually variable period of immobilization, with the aim of restoring flexibility, coordination and strength (closed chain). If the treatment is insufficient and chronic synovitis develops, consideration must be given after 2-3 month of early synovectomy, by chemical, radio-active, arthroscopic techniques, or by arthrotomy. The physical therapy following operations of this sort should be regarded as the same as for acute synovitis. The rehabilitation of synovitis is independent of co-infections.