Radiological Stage of Hemophilic Arthropathy of Knee Does Not Correlate With Clinical Variables

Various functional and radiological systems have been developed to evaluate joint health and the severity of arthropathy in hemophilic patients. Clinical relevance of these radiological systems has received minimal attention.

Through a retrospective chart review, 84 patients with end-stage hemophilic arthropathy of the knee were included. Pettersson and Arnold-Hilgartner scores were assessed by two observers. Correlation between radiological stage and range of motion (ROM), KSS function subscores, KSS pain subscores, total KSS, and surgical time were analyzed.

Interobserver correlation was found to be very strong for Pettersson score, with a value of 0.84 (95% CI: 0.75-0.89) and moderate for the Arnold-Hilgartner with kappa value of 0.4 (95% CI: 0.17-0.62). Correlation between Pettersson score and clinical variables revealed a very weak inverse correlation with ROM (r = -0.12, 95% CI: -0.33 to 0.10), KSS pain (r = -0.09, 95% CI: -0.31 to 0.12), and KSS function (r = -0.16, 95% CI: -0.36 to 0.06), and weak inverse correlation with KSS (r = -0.24, 95% CI: -0.44 to 0.2). Regarding the correlation between Arnold-Hilgartner score, a weak inverse correlation was observed with ROM (r = -0.21, 95% CI: -0.41 to 0.00), and very weak inverse correlations with KSS pain (r = -0.06, 95% CI: -0.16 to 0.27), KSS function (r = -0.00, 95% CI: -0.22 to 0.21), and KSS (r = -0.04, 95% CI: -0.25 to 0.18).

Radiologic staging systems demonstrate weak correlation with clinically meaningful variables in patients with end-stage hemophilic arthropathy of knee, an important consideration in the management of hemophilic arthropathy.