Joint Damage as a Result of Hemarthrosis

  • Goris Roosendaal
  • Floris P. J. G. Lafeber


The immediate symptoms or “short-term” effects of hemarthrosis are pain, swelling, warmth, and muscle spasm. The “long-term” effects of recurrent joint bleeding are more serious. Repeated episodes of intra-articular bleeding cause damage to the joint, leading to deformity and crippling [1, 2]. However, the delay between joint bleeding and the subsequent joint damage makes it difficult to establish the exact pathogenetic mechanism of blood-induced joint damage.


Articular Cartilage Joint Damage Cartilage Damage Proteoglycan Synthesis Proteoglycan Content 
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  1. 1.
    van Creveld S, Hoedemaker PJ, Kingma MJ, Wagenvoort CA (1971) Degeneration of joints in haemophiliacs under treatment by modern methods. J Bone Joint Surg 53:296–302Google Scholar
  2. 2.
    Madhok R, Bennett D, Sturrock RD, Forbes CD (1988) Mechanisms of joint damage in an experimental model of haemophilic arthritis. Arthritis Rheum 31:1148–1155PubMedCrossRefGoogle Scholar
  3. 3.
    Stein H, Duthie RB (1981) The pathogenesis of chronic haemophilic arthropathy. J Bone Joint Surg 63B:601–609Google Scholar
  4. 4.
    Madhok R, York J, Sturrock RD (1967) Haemophilic arthritis. Ann Rheum Dis 50:588–591CrossRefGoogle Scholar
  5. 5.
    Hoaglund FT. Experimental hemarthrosis. The response of canine knees to injections of autologous blood. J Bone Joint Surg 49:285–298Google Scholar
  6. 6.
    Zeman DH, Roberts ED, Shoji H, Miwa T (1991) Experimental haemarthrosis in rhesus monkeys: morphometric, biochemical and metabolic analyses. J Comp Pathol 104:129–139PubMedCrossRefGoogle Scholar
  7. 7.
    Wolf CR, Mankin HJ (1965) The effect of experimental hemarthrosis on articular cartilage of rabbit knee joints. J Bone Joint Surg Am 47:1203–1210PubMedGoogle Scholar
  8. 8.
    Roy S, Ghadially FN (1966) Pathology of experimental haemarthrosis. Ann Rheum Dis 25:402–415PubMedGoogle Scholar
  9. 9.
    Mainardi CL, Levine PH, Werb Z, Harris ED (1978) Proliferative synovitis in hemophilia: biochemical and morphologic observations. Arthritis Rheum 21:137–144PubMedCrossRefGoogle Scholar
  10. 10.
    Pelletier J-P, Martel-Pelletier J, Ghandur-Mnaymneh L et al (1985) Role of synovial membrane inflammation in cartilage matrix breakdown in the Pond-Nuki model of osteoarthritis. Arthritis Rheum 28:554–561PubMedCrossRefGoogle Scholar
  11. 11.
    Abrahams TG, Pavlov H, Bansal M, Bullough P (1988) Concentric joints space narrowing of the hip associated with hemosiderotic synovitis (HS) including pigmented villonodular synovitis (PVNS). Skeletal Radiol 17:37–45PubMedCrossRefGoogle Scholar
  12. 12.
    France MP, Gupta SK (1991) Non-haemophilic hemosiderotic synovitis of the shoulder. A case report. Clin Orthop 262:132–136PubMedGoogle Scholar
  13. 13.
    Morris CJ, Blake DR, Wainwright AC, Steven MM (1986) Relationship between iron deposits and tissue damage in the synovium: an ultra structural study. Ann Rheum Dis 45:21–26PubMedCrossRefGoogle Scholar
  14. 14.
    Blake DR, Gallagher PJ, Potter AR et al (1984) The effect of synovial iron on the progression of rheumatoid disease. A histologic assessment of patients with early rheumatoid synovitis. Arthritis Rheum 27:495–501PubMedCrossRefGoogle Scholar
  15. 15.
    Roosendaal G, Vianen ME, Wenting MJG et al (1998) Iron deposits and catabolic properties of synovial tissue from patients with haemophilia. J Bone Joint Surg 80B:540–545CrossRefGoogle Scholar
  16. 16.
    Roosendaal G, Van Rinsum AC, Vianen ME et al (1999) Haemophilic arthropathy resembles degenerative rather than inflammatory joint disease. Histopathology 34:144–153PubMedCrossRefGoogle Scholar
  17. 17.
    Roosendaal G, Vianen ME, van den Berg HM et al (1997) Cartilage damage as a result of hemarthrosis in a human in vitro model. J Rheumatol 24:1350–1354PubMedGoogle Scholar
  18. 18.
    Roosendaal G, Vianen ME, Marx JJM et al (1999) Blood induced joint damage: a human in vitro study. Arthritis Rheum 42:1025–1032PubMedCrossRefGoogle Scholar
  19. 19.
    Lafeber FP, Vander Kraan PM, van Roy JL et al (1993) Articular cartilage explant culture; an appropriate in vitro system to compare osteoarthritic and normal human cartilage. Connect Tissue Res 1993;29:287–299PubMedCrossRefGoogle Scholar
  20. 20.
    Hooiveld MJJ, Roosendaal G, Van den Berg HM et al (2003) Blood-induced joint damage: long-term effects in vivo and in vitro. J Rheumatol 30(2):339–344PubMedGoogle Scholar
  21. 21.
    Niibayashi H, Shimizu K, Suzuki et al (1995) Proteoglycan degradation in hemarthrosis. Intraarticular, autologous blood injection in rat knees. Acta Orthop Scand 66:73–79PubMedCrossRefGoogle Scholar
  22. 22.
    Van Roon JA, van Roy JL, Lafeber FP, Bijlsma JW (1996) The stimulation of mononuclear cells from patients with rheumatoid arthritis to degrade articular cartilage is not modulated by cartilage itself. Clin Exp Rheumatol 14(2):177–182PubMedGoogle Scholar
  23. 23.
    Bates EJ, Lowther DA, Handley CJ (1984) Oxygen free-radicals mediate an inhibition of proteoglycan synthesis in cultured articular cartilage. Ann Rheum Dis 43:462–469PubMedCrossRefGoogle Scholar
  24. 24.
    Burkhardt H, Schwingel M, Menninger H et al (1986) Oxygen radicals as effectors of cartilage destruction. Direct degradative effect on matrix components and indirect action via activation of latent collagenase from polymorphonuclear leukocytes. Arthritis Rheum 29:379–387PubMedCrossRefGoogle Scholar
  25. 25.
    Hooiveld MJJ, Roosendaal G, Wenting M et al (2003) Short-term exposure of cartilage to blood results in chondrocyte apoptosis. Am J Pathol 162(3):943–951PubMedGoogle Scholar
  26. 26.
    Hooiveld MJJ, Roosendaal G, van den Berg HM et al (2003) Hemoglobin-derived irondependent hydroxyl radical formation in blood-induced joint damage: an in vitro study. Rheumatology 42:784–790PubMedCrossRefGoogle Scholar
  27. 27.
    Roosendaal G, TeKoppele JM, Vianen ME et al (1999) Blood induced joint damage: a canine in vivo study. Arthritis Rheum 42:1033–1039PubMedCrossRefGoogle Scholar
  28. 28.
    Roosendaal G, TeKoppele JM, Vianen ME et al (2000) Articular cartilage is more susceptible to blood-induced cartilage damage at young age than old age. J Rheumatol 27:1740–1744PubMedGoogle Scholar
  29. 29.
    Hooiveld MJJ, Roosendaal G, Vianen M et al (2003) Immature articular cartilage is more susceptible to blood-induced damage than mature articular cartilage: an animal in vivo study. Arthritis Rheum 48(2):396–403PubMedCrossRefGoogle Scholar
  30. 30.
    Hooiveld MJJ, Roosendaal G, Jacobs K et al (2004) Experimental joint bleeds, combined with loading of the joint initiates degenerative joint damage: a possible mechanism in hemophilic arthropathy. Arthritis Rheum 50(6):2024–2031PubMedCrossRefGoogle Scholar
  31. 31.
    Convery FR, Woo SL, Akeson WH, Amiel D et al (1976) Experimental hemarthrosis in the knee of the mature canine. Arthritis Rheum 19:59–67PubMedCrossRefGoogle Scholar
  32. 32.
    Parsons JR, Zingler BM, McKeon JJ (1987) Mechanical and histological studies of acute joint hemorrhage. Orthopedics 10:1019–1026PubMedGoogle Scholar

Copyright information

© Springer 2008

Authors and Affiliations

  • Goris Roosendaal
    • 1
  • Floris P. J. G. Lafeber
    • 1
  1. 1.Van Creveldkliniek, National Hemophilia Treatment Centre, Department of Rheumatology and Clinical ImmunologyUniversity Medical Centre UtrechtUtrechtThe Nederlands

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