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Joint pain with radiographic evidence of joint space narrowing
1%
8/592
Joint stiffness that has not improved with physiotherapy and bracing
20%
119/592
Recurrent joint bleeding despite optimal medical management
66%
390/592
Prophylaxis for joint preservation in severe hemophilia (factor VIII level <1%)
7%
39/592
Decreasing ambulatory endurance despite optimal medical management
6%
34/592
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Improved medical management has changed musculoskeletal outcomes for individuals with hemophilia. Patients with severe hemophilia receiving prophylactic administration of factor VIII may never develop a target joint that requires further orthopaedic intervention. Patients with moderate hemophilia and those patients with severe hemophilia not receiving prophylactic treatment will still develop joints that have recurrent hemarthroses. When recurrent hemarthrosis continues despite optimal medical management, synovectomy is indicated. While synovectomy is predictable in its ability to decrease joint bleeding, it does not necessarily improve joint range of motion or prevent the development of hemophilic arthropathy over time. It will not reverse articular damage to the joint once it has developed.
1.8
(13)
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