“OUTCOME ANALYSIS OF TIMELY CONSERVATIVE MANAGEMENT OF HAEMOPHILIC KNEE ARTHROPATHY WITH FACTOR REPLACEMENT AND PHYSIOTHERAPY.”

Abstract

INTRODUCTION: Haemophilia is a disorder of the initiation of coagulation, and is due to reductions in the concentrations of, or the presence of a less active version of, one of two coagulation factors, factor VIII and factor IX. There are several orthopaedic problems linked to haemophilia including recurrent hemarthroses, chronic synovitis, exion deformities, hypertrophy of the growth epiphyses, damage to the articular cartilage and hemophilic arthropathy MATERIALS AND METHODS : 290 patients of all age group of haemophilia A and B coming to orthopaedic OPD with Knee Haemarthosis between October 2018 to May 2020 were included in our study. These patients were prospectively analyzed for complications and severity. HJHS Scoring system were used to assess the severity of joint disease. RESULTS : . out of 290 patients it was found that haemophilia was more prevalent in rural population (53.10%) as compared to urban population (46.90%). In our study it was found that majority of the patients with haemophilia had single joint involved (57.94%) as compared to 42.06% who had multiple joint involved. It was revealed that in majority right knee was involved (52.41%) followed by left joint in 47.58% patients with haemophilia. It was found that most common complication in patients of knee haemarthrosis was recurrent haemarthrosis (57.24%) followed by synovitis (27.93%). arthropathy (9.31%) . It was found that most common complication in patients of knee haemarthrosis was recurrent haemarthrosis (57.24%) followed by synovitis (27.93%). arthropathy (9.31%) . It was found that out of 290 patients with haemophilia, majority were performing regular physiotherapy (57.59%) followed by 42.41% of the patients who were occasional in physiotherapy. It was found that mean HJHS score was increasing with increasing the severity of the disease. Mean HJHS score for mild cases was 10.53±4.495 as compared to 13.06±7.575 of moderate cases and 17.82±7.991 of severe cases. CONCLUSION In present study haemophilia was more prevalent in rural population. Majority of the patients with haemophilia had single joint and in majority right knee was involved. Most common complication in patients of haemophilia was recurrent haemarthrosis followed by synovitis and arthropathy. Majority of our patients were having severe form of the disease. Adequate factor replacement along with good active physiotherapy early detection and prompt treatment with active life style makes muscles and joints healthier and stronger reduces tendancy of bleeding and further damage of joint. reduce the frequency and longterm complications of knee haemarthrosis like recurrent haemarthosis , synovitis ,arthropathy, fracture and deformity. Prophylactic factor replacement is having denitely positive role as per available literature over western countries, unfortunately it needs more specic clinical trial to know about longterm good results in India.