Comparative Analysis of Platelet-rich Plasma Treatment for Chronic Synovitis in Patients With Hemophilia: A Six-month Follow-up

Abstract

Background: Inhibitor development is the main treatment-related complication in patients with hemophilia. Degenerative joint lesions caused by repeated bleeding episodes are more common in patients with inhibitors than in those without inhibitors. We introduced Platelet-rich Plasma (PRP) treatment to reduce joint damage and provide symptomatic relief. Objectives: The aim of this study was to compare PRP treatment outcomes in two groups of patients with hemophilia presenting synovitis, with or without inhibitors, at 3- and 6-month follow-ups. Methods: We treated 87 patients with 143 affected joints divided into two groups: 78 patients without inhibitors with 129 affected joints and a mean age of 25.8 years, and 9 patients with inhibitors with 14 affected joints and a mean age of 16.3 years. Results: The difference in mean age between the two groups was statistically significant (P=0.007). The number of bleeding episodes, Visual Analogue Scale (VAS), and Hemophilia Joint Health Score (HJHS) before treatment and after three and six months showed no statistically significant differences between groups. We demonstrated that PRP treatment decreased the number of bleeding episodes, pain levels, and HJHS in the whole study population (P<0.001). No differences were found between patients with and without inhibitors. Conclusion: PRP was proved to be effective for synovitis treatment in patients with hemophilia with and without inhibitors.