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Accelerating recovery from acute hemarthrosis in patients with hemophilia

the role of joint aspiration

De la Corte-Rodriguez, Hortensiaa; Rodriguez-Merchan, E. Carlosb; Alvarez-Roman, Maria Teresac; Martin-Salces, Monicac; Romero-Garrido, Jose A.d; Jimenez-Yuste, Victorc

Blood Coagulation & Fibrinolysis: April 2019 - Volume 30 - Issue 3 - p 111–119
doi: 10.1097/MBC.0000000000000803
ORIGINAL ARTICLES
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Joint aspiration (arthrocentesis) of an acute hemarthrosis in hemophilia remains a controversial issue. The purpose of this study is to define the role that joint aspiration can play in the recovery from acute hemarthrosis in patients with hemophilia. The study sample included 33 hemophilic patients (55 joints) with acute elbow, knee, and ankle hemarthrosis as confirmed by ultrasonography. Patients were distributed into a treatment group and a control group. Patients in the first group were subjected to joint aspiration, whereas patients in the second were not. Arthrocentesis was carried out immediately after diagnosis of acute hemarthrosis in liquid phase. Patients were infused with the deficient coagulation factor and were instructed to observe relative rest until resolution of hemarthrosis. The following parameters were analyzed: time to full resolution of hemarthrosis (determined by ultrasonography), duration of treatment with the deficient coagulation factor, time to pain relief, time to recovery of prebleed range of motion, and time to resumption of school/work (all of these measured in days). The joints treated with joint aspiration exhibited a significantly faster resolution of bleeding (fewer days). In addition, this group required fewer days of hematological treatment, with faster achievement of functional recovery and resumption of school/work activities. No complications were observed. This study shows that joint aspiration under hemostatic cover and in strictly aseptic conditions is a well-tolerated technique that makes the recovery of acute hemarthrosis of hemophilic patients faster.

aDepartment of Physical Medicine and Rehabilitation

bDepartment of Orthopaedic Surgery

cDepartment of Hematology

dDepartment of Pharmacy, La Paz University Hospital-IdiPaz, Madrid, Spain

Correspondence to Emerito Carlos Rodriguez-Merchan, MD, Ph.D., Department of Orthopaedic Surgery, La Paz University Hospital-IdiPaz, Paseo de la Castellana 261, 28046 Madrid, Spain. E-mail: ecrmerchan@hotmail.com

Received 7 December, 2018

Revised 21 January, 2019

Accepted 19 February, 2019

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