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Management of Acute Hemarthrosis in Hemophilia (Including Joint Aspiration)

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Advances in Hemophilia Treatment

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Abstract

Hematologic primary prophylaxis is the gold standard of treatment in persons with hemophilia (PWH). The goal is to reduce or prevent joint bleeds and subsequent joint degeneration (hemophilic arthropathy). In acute hemarthroses, early treatment with factor VIII or factor IX (FVIII or FIX) replacement and rest of the joint (4–5 days) is paramount. In patients with inhibitors (antibodies against FVIII or FIX) we can use bypassing agents such as activated prothrombin complex concentrates (aPCCs) and recombinant factor VIIa (rFVIIa). The goal is to get the rapid resolution of the joint bleed that must be confirmed by means of ultrasonography (US). This way the risk of long-term complications will be minimized. Ice therapy could help, although its current role in hemophilia remains controversial. Pain killers (paracetamol) may also be needed. Arthrocentesis (joint aspiration) should be performed in very tense and painful joints. The procedure should always be performed under factor coverage and in aseptic conditions.

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Authors and Affiliations

  1. Department of Orthopedic Surgery, La Paz University Hospital, Madrid, Spain

    E. Carlos Rodríguez-Merchán

  2. Department of Physical and Rehabilitation Medicine, La Paz University Hospital, Madrid, Spain

    Hortensia De la Corte-Rodríguez

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  1. E. Carlos Rodríguez-Merchán
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  2. Hortensia De la Corte-Rodríguez
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Editors and Affiliations

  1. Department of Orthopedic Surgery, La Paz University Hospital, Madrid, Spain

    E. Carlos Rodríguez-Merchán

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Rodríguez-Merchán, E.C., De la Corte-Rodríguez, H. (2022). Management of Acute Hemarthrosis in Hemophilia (Including Joint Aspiration). In: Rodríguez-Merchán, E.C. (eds) Advances in Hemophilia Treatment . Springer, Cham. https://doi.org/10.1007/978-3-030-93990-8_13

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  • DOI: https://doi.org/10.1007/978-3-030-93990-8_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-93989-2

  • Online ISBN: 978-3-030-93990-8

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