Haemophilic Elbow Arthropathy: Mechanisms, Management and Future Perspectives

Haemophilic elbow arthropathy (HEA) causes pain, limits mobility, and impairs upper limb function, often unrecognised until irreversible damage has occurred.

This narrative review sought to provide an updated overview of the current state of HEA knowledge, treatment approaches, and future perspectives.

We searched the PubMed/Medline, Embase and Scopus (through April 2025) databases for English articles using a combination of controlled vocabulary and free-text keywords related to haemophilia, elbow arthropathy, range of motion, physiotherapy, surgical interventions, and joint assessment. The review was organised around six key themes: normal function of the elbow, progressive loss of its mobility and functionality, monitoring, role of physiotherapy and exercise, invasive solutions, and future perspectives. A total of 60 articles were retrieved, 45 of which were examined in depth.

HEA significantly affects the quality of life of people with haemophilia (PwH). Its insidious onset, coupled with the body's ability to compensate, frequently obscures the severity of mobility loss, leading to delayed interventions and irreversible joint damage. Early detection, precise monitoring, and targeted physiotherapy are crucial to slowing down disease progression and optimising functional outcomes. Surgical interventions are considered only in advanced-stage HEA, and are typically reserved for cases where conservative treatments have proven insufficient. Technological and telemedicine advances provide novel avenues to optimise care and promote patient self-management.

HEA is a progressive, often overlooked condition that reduces quality of life in PwH, highlighting the need for early detection, monitoring, and targeted physiotherapy to prevent irreversible joint damage.