HoG Handbook



joint bleedsArthritis in people with hemophilia is caused by frequent or inadequately treated bleeding into joints.  It is sometimes called degenerative joint disease.  It may be the most common complication of severe hemophilia.  Arthritis can be avoided by properly taking care of joint bleeds.  Once it occurs, it is difficult to treat.

When bleeding is not stopped quickly, blood fills the space in the joint.  The cells the body sends in to digest the blood also destroy the cartilage that pads the ends of the bones.  Over time, the bones rub against each other and begin to wear away.  Scar tissue builds up in the joint.  The nearby muscles waste away from disuse.  The result can be chronic pain and crippling.

Sometimes you may be unsure whether a joint is hurting from arthritis or from a bleed.  If so, treat with factor.  If taking factor does not relieve the pain, you can suspect arthritis.  Your HTC can help with treatment.

Signs and symptoms of arthritis

  • Pain and aching in the joints.
  • Stiffness, especially in the morning.
  • Decreased flexibility.
  • The feeling that the limb is "frozen" in place.
  • Gradual muscle weakening from lack of use.
  • A possible decrease in the number of bleeds since the joint's blood vessel system is destroyed.

Treatment for arthritis

If you have arthritis, your treatment should include some form of exercise.  Exercise will help you move more easily and will make your muscles stronger.  This will reduce your chances of having more bleeds.  Your physical therapist can teach you the best exercises for your condition.  Physical therapy can also help relieve pain and decrease the crippling caused by arthritis.

Arthritis treatment may include anti-inflammatory drugs and, if needed, medicine for pain.  Many of the arthritis medicines you can buy off the shelf in the drugstore have aspirin in them.  Do not take these, as aspirin can cause more bleeding.  To check for aspirin, read the label carefully or ask the pharmacist.  Your HTC can tell you which medicines are safe to take.

Your orthopedist (joint doctor) may want you to use assistive devices such as splints or other supports for your joints.  Sometimes orthopedists treat arthritis with surgery to replace the destroyed joint.  The advantages of replacing the joint are less pain and more movement in the joint.  The disadvantage is major surgery, which requires a lot of factor and rehabilitation.  At this time, joint replacement is not a permanent solution.  It is not done on children and teens whose bones are still growing.

Ways to prevent arthritis

  • Exercise regularly to improve motion and muscle strength.
  • Treat joint bleeds quickly.
  • Visit your HTC regularly for check-ups, including an exam by the orthopedist (joint doctor).