Range of motion after total knee arthroplasty in hemophilic arthropathy.

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Abstract

[Indexed for MEDLINE] Conflict of interest statement: ETHICS APPROVAL AND CONSENT TO PARTICIPATE: Ethic committee Na Bulovce Hospital, No: 4.12.2017/8660/EK-Z. CONSENT FOR PUBLICATION: All participants included into study signed informed consents, that data of examination at University hospital can be published. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER’S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. 15. J Jpn Phys Ther Assoc. 2015;18(1):15-22. doi: 10.1298/jjpta.Vol18_003. Joint Function and Arthropathy Severity in Patients with Hemophilia. Goto M(1), Takedani H(2), Nitta O(3), Kawama K(4). Author information: (1)The University of Tokyo Hospital. (2)IMSUT Hospital of the Institute of Medical Science, The University of Tokyo. (3)Tokyo Metropolitan University. (4)University of Tsukuba. BACKGROUND: The Arnold-Hilgartner classification is one of the most popular evaluation systems for the progression hemophilic arthropathy. A previous study reported an association between arthropathy severity and arc range of motion (ROM). However, associations between arthropathy severity and angular ROM and muscle strength remain unclear. AIM: The purpose of this study was to clarify the association between joint function and arthropathy severity in hemophilia. METHODS: We studied the knee, ankle, and elbow joints of 31 patients with hemophilia (PWH). The condition of the affected joints was evaluated on the basis of the interview data, joint function measurements, and roentgenography of the affected joints. In assessment of joint function, we evaluated knee strength (flexor, extensor) and grip strength as well as the passive ROM of the elbow, knee, and ankle. During the interview, all patients were asked about the history of intra-articular bleeding over the past year and pain. RESULTS: As arthropathy severity worsened, knee flexor strength, knee extensor strength, grip strength, and ROM (elbow flexion, elbow extension, knee flexion, knee extension, and ankle extension) significantly decreased. Even patients with mild arthropathies experienced knee extensor weakness and extension limitation. In addition, joint function of severe ankle arthropathy was significantly related to the history of intra-articular bleeding and pain. CONCLUSION: Our results suggest that physical therapy is necessary to improve joint function in PWH and mild or no arthropathy. Pain control and prophylactic hematological management are necessary for patients with severe arthropathy because intra-articular bleeding and pain significantly decrease joint function. DOI: 10.1298/jjpta.Vol18_003 PMCID: PMC4691580