Management of haemophilic arthropathy
Autor: | V. Molina, Y. Carrillon, D. Bossard, G. Dirat, Y. Laurian, J.-P. Larbre, N. Stieltjes |
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Rok vydání: | 2008 |
Předmět: |
medicine.medical_specialty
medicine.medical_treatment Context (language use) Synovectomy Hemophilia A Haemophilia Hemarthrosis Arthropathy Humans Medicine Orthopedic Procedures Intensive care medicine Physical Therapy Modalities Genetics (clinical) Clotting factor Rehabilitation biology business.industry Hematology General Medicine medicine.disease Magnetic Resonance Imaging Blood Coagulation Factors Recombinant factor VIIa biology.protein Physical therapy Joints business |
Zdroj: | Haemophilia. 14:11-19 |
ISSN: | 1365-2516 1351-8216 |
Popis: | Despite the tremendous benefit offered by primary prophylaxis, recurrent joint bleeding with progression to chronic synovitis and haemophilic arthropathy is still a daily concern for the multidisciplinary health care teams managing patients with severe haemophilia or haemophilia complicated by inhibitor development. Advanced stages of arthropathy could be prevented by regular assessment of musculoskeletal status and thus early detection of symptoms, daily rehabilitation exercises at home, and implementation of appropriate physiotherapy and medical training. Patient's education and psychological counselling are crucial. New tools such as magnetic resonance imaging are promising for the monitoring of these patients and might promote early detection of arthropathy and thus appropriate preventive measures to avoid further joint deterioration can be implemented. Medical synovectomy such as radionucleide synoviorthesis is a simple and non-invasive procedure that often delays the need for surgery which despite considerable improvement in techniques and postoperative rehabilitation remains a high-risk strategy in patients with severe haemophilia, especially those with inhibitors. In these high risk patients, availability of specific clotting factors such as activated prothrombin complex concentrate (FEIBA, Baxter, Vienna, Austria) and more recently, recombinant factor VIIa (rFVIIa, NovoSeven, Bagsvaerd, Denmark) has allowed to perform effective and safe orthopaedic procedures. The on-going EUREKA study will undoubtedly provide additional information about the optimal use of rFVIIa in this context. |
Databáze: | OpenAIRE |
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