Study of musculoskeletal complications of hemophilia at a tertiary health-care center in Central India

Abstract

Background: Hemophilia A, an X-linked recessive disorder of coagulation, caused due to the deficiency of coagulation factor-VIII and hemophilia-B caused due to the deficiency of factor-IX cause spontaneous and traumatic bleeding episodes, leading to various musculoskeletal complications. Materials and Methods: This study was conducted at the Department of Orthopaedics, Hamidia Hospital, Bhopal, for 2 years. After obtaining ethical clearance and consent from the participants, a total of 101 hemophiliac patients were clinically examined, and blood investigations and radiological evaluation were done. Their data were collected using a preformed pro forma. Results: Of the 101 patients, 91 (90.10%) patients had hemophilia A and 10 (9.90%) patients had hemophilia type-B. The mean age of the study population was 20.87 years. Severe (Grade III) hemophilia was more common, with 59.34% cases of hemophilia A and 60% cases of hemophilia B. Fifty-four (53.47%) patients were from rural area. The most common complication was hemarthrosis in 91 patients followed by hemophilic arthropathy in 64 patients, synovitis in 33 patients, and muscle hematoma in 18 patients. Among the 101 patients, 184 joints involved as target joints. Knee joint was the most commonly involved joint (51.09%) followed by elbow (25.54%) and ankle (15.76%). The most common muscle hematoma was psoas muscle hematoma in six (31.58%) patients followed by calf muscle hematoma in four (21.05%) patients. Conclusion: Hemophilia A is most common type causing bleeding in the knee joint and produces arthropathy. It needs prompt factor infusion and physiotherapy to reduce complications.

Keywords

• arthropathy
• hemophilia a
• hemophilia b
• musculoskeletal complications