Common orthopaedic problems in haemophilia.

The most important fact in patients with haemophilia is the avoidance of recurrent haemarthroses by means of haematological prophylaxis. Unfortunately this is not currently possible in the majority of countries around the world. When only on-demand haematological treatment is available, frequent evaluations are necessary for the early diagnosis and treatment of intra-articular bleeding episodes. The typical outcome of these patients is towards the development of chronic synovitis, and later on to haemophilic arthropathy, if the state of synovitis is not promptly and adequately controlled. Once arthropathy develops the functional prognosis is poor, although haemophilic patients use to tolerate very well their tremendous joints destructions. Treatment of these patients should be performed in a comprehensive basis within a multidisciplinary haemophilia unit.