Prevention of haemophilic arthropathy.

Early and adequate treatment of haemarthroses, will prevent or lessen future arthropathy. A prospective double blind controlled study of three different dose regimes of Factor VIII in the treatment of haemarthroses of the knees, elbows and ankles has shown that site and severity affect the initial response and should dictate the dose. High risk bleeds can be identified by the degree of movement loss and the presence of pain at rest, and tenderness. Reassessment of bleeds will indicate those not responding. Early recognition of delayed restoration of function requires an analysis of the normal processes. A study has revealed that the mean time for complete restoration of function was 3.6 +/- 3.3 days for elbows, 2.5 +/- 2.1 for knees and 1.1 +/- 0.9 for ankles. Departure from these norms should signal the need for early physiotherapeutic intervention.