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Joint Damage

A joint is an area where two bones come together and joint damage is one of the most common complications of hemophilia.  That’s because people with hemophilia can bleed into a joint space after an injury or even without a specific cause. The blood filling into the joint cavity can exert pressure and lead to severe pain, swelling and even deformities. In most cases, the joints typically affected are the elbows, ankles and knees.

Joint damage in people with a hemophilia is similar to joint damage of a person with arthritis. The damage occurs in the synovium, a lining that lubricates and feeds the joint, and the cartilage around the bones.

The synovium has blood vessels in it and this explains why bleeding into the joints is common in people with a bleeding disorders. One of the synovium’s functions is to remove fluid from joints so when blood enters the joint, cavity, the synovium absorbs it. Boood has iron in it, and it is believed that the absorption of the iron in blood stimulates the growth of the synovium, causing it to thicken and increase its number of blood vessels. This, in turn, increases the likelihood of bleeding into the joint.  

One of methods used to treat joint damage is called a synovectomy.

A synovectomy is the removal of the synovium and it stops the bleeding cycle caused by the thick synovium.  There are three types of synovectomies used to alleviate pain and improve function of the joint: radioactive, arthroscopic and open.