Repeated joint
bleeding leads to chronic
synovitis, cartilage damage and bone alterations which result in haemophilic
arthropathy and are associated with
pain, functional impairment and poor quality of life. There are evidence that
Hyaluronic Acid (HA) and Platelet-rich Plasma (PRP) have different mechanisms of action in the treatment of
arthropathy for this reason we decided to use both components. The aim of this study is to compare, the efficacy, safety and duration of a single
intra-articular injection of PRP against PRP+HA for
pain,
bleeding episodes and joint health, in the same patient with bilateral hemophilic knee
arthropathy. Twenty-one men patients (42 knee joints) were treated with
intra- articular injections of PRP or PRP+HA. All of them were
haemophilia type A severe. The mean age was 36.6 years (21-72). All patients were evaluated for:
Haemophilia Joint Health Score (HJHS),
pain (VAS), the number of
bleeding episodes (BE) in the last 30 days, before treatment, at three and six months
after treatment. Statistically significant improvement were shown for both knee joints at three and six months
after treatment for VAS and BE (P < 0.00001). The HJHS score did not significantly improve for either knee in the 6-month period after injection. A single PRP or PRP+HA injection is safe and effective in treating haemophilic
arthropathy of the knee for up to 6 months follow-up, reducing
pain,
bleeding episodes and delaying
total knee arthroplasty.