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Developmental Changes in Haemophilic Knee Joint Morphology: A Geometric Morphometric Study.

Chieh-Yu Lin1, Peng-Ta Liu1,2,3, Ming-Ching Shen4

  • 1Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan.

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|September 30, 2025
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Summary

Geometric morphometrics revealed significant age-related knee joint changes in haemophilia patients, with patellar position being a key indicator for monitoring and rehabilitation.

Keywords:
geometric morphometric measurementhaemophilia arthropathyknee jointprocrustes analysisradiography

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Area of Science:

  • Orthopedics
  • Radiology
  • Developmental Biology

Background:

  • Haemophilia significantly impacts joint health throughout life.
  • Developmental morphological changes in haemophilic bones are not well understood.
  • Geometric morphometric measurement (GMM) was used to analyze knee joint morphology in haemophilia.

Purpose of the Study:

  • To investigate age-related morphological variations in the knee joints of haemophilia patients.
  • To identify key morphological markers for monitoring disease progression.
  • To inform the development of targeted rehabilitation strategies.

Main Methods:

  • Retrospective analysis of 210 knee radiographs from 15 male haemophilia patients (ages 8-24).
  • 2D bony landmarks were annotated, and Generalized Procrustes analysis was performed.
  • Principal component analysis, Procrustes ANOVA, and multivariate regression were used to assess shape differences and associations with clinical scores (PS, HJHS).

Main Results:

  • Significant morphological differences (p < 0.001) were observed among age groups.
  • The first five principal components explained 83% of morphological diversity.
  • Medial patellar displacement and joint space reduction were notable alterations, with significant differences between the youngest and oldest age groups.

Conclusions:

  • Significant age-related morphological alterations occur in the knee joints of haemophilia patients.
  • Patellar position is a crucial morphological marker for long-term follow-up.
  • Findings support the development of tailored rehabilitation programs for haemophilia.