Elbow arthropathy in hemophilia

Citation
R. Malhotra et al., Elbow arthropathy in hemophilia, ARCH ORTHOP, 121(3), 2001, pp. 152-157
Citations number
11
Language
INGLESE
art.tipo
Article
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine
Journal title
ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
ISSN journal
0936-8051 → ACNP
Volume
121
Issue
3
Year of publication
2001
Pages
152 - 157
Database
ISI
SICI code
0936-8051(200102)121:3<152:EAIH>2.0.ZU;2-O
Abstract
Twenty-one affected elbows in 14 known hemophilic patients undergoing treat ment at the Hemophilia Clinic of our institution between 1994 and 1997 were evaluated using the clinical evaluation score of the Orthopaedic Advisory Committee of the World Federation of Hemophilia and radiological examinatio n using the Pettersson score. The mean age of patients was 16.2 years (rang e 10-25 years), and all patients except 1 had severe hemophilia with factor VIII levels less than 1% of normal. The mean duration of disease at the ti me of presentation was 12.8 years. The mean clinical score was 6, while the mean radiological score was 4.9. There was a positive correlation between the clinical and radiological scores (P < 0.0001). However, the clinical an d radiological scores did not correlate with either duration of disease or joint bleeding score. Two new radiological signs of obliteration of the cap itello-lateral epicondyle groove with rounding off of the lateral aspect of the distal humerus and ripping of the medial trochlear surface were also r ecognized in hemophilic arthropathy of the elbow. Attempts have been made i n the past to classify cases with hemophilic arthropathy based on the clini cal and the radiological signs. Pettersson et al. [10] introduced a score b ased on certain representative changes seen on plain radiography. The Ortho paedic Advisory Committee of the World Federation of Hemophilia accepted th e Pettersson score in 1981, and incorporated it in a point-based, clinico-r adiologic comprehensive classification [5]. The present study applies this classification to quantify the changes of hemophilic arthropathy of the elb ow joint: and attempts to correlate the degree of joint involvement graded by radiological criteria with clinical grading of the arthropathy.