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Updated: May 3, 2026

Clinical Protocol of Producing Adipose Tissue-Derived Stromal Vascular Fraction for Potential Cartilage Regeneration
Published on: September 29, 2018
Viscosupplementation in patients with hemophilic arthropathy
Flávio Zelada1, Adriano Marques de Almeida1, Alexandre Felicio Pailo1
1Institute of Orthopedics and Traumatology of Hospital das Clà nicas da Faculdade de Medicina da Universidade de São Paulo.
Objective:
To assess whether viscosupplementation with hyaluronic acid in patients with severe hemophilic arthropathy associated with triamcinolone after washing with saline improves joint pain, stiffness, function and quality of life.
Methods:
Eleven patients with hemophilic arthritis of the knee with and without involvement of other joints (elbows and ankles) underwent joint lavage with saline and subsequent injection of Hylan and triamcinolone in all affected joints. The patients answered the algo-functional (Lequesne and WOMAC), visual analog scale for pain (VAS) and SF-36 (quality of life) questionnaires preoperatively, and at one and three months postoperatively.
Results:
Pain (VAS and WOMAC pain) and stiffness (WOMAC stiffness) did not show significant improvement (p = 0.3, p = 0.2, p = 0.1, respectively). However function had significant improvement given by WOMAC total and function (averaging 11 points, p = 0.04 and p = 0.001). There was no significant variation in scores in Lequesne's questionnaire (p = 0.1), yet both mental and physical components of SF-36 presented clinically relevant and significant improvements (p = 0.002).
Conclusion:
Joint lavage with saline followed by injection of corticosteroids and Hylan is effective in the treatment of hemophilic arthropathy, especially in functional improvement and quality of life. Level of Evidence IV, Case series.
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