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J. Clin. Med. 2017, 6(4), 44; doi:10.3390/jcm6040044

Hip Arthropathy in Haemophilia

Orthopaedic Clinic, University of Florence, Florence 50139, Italy
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Author to whom correspondence should be addressed.
Academic Editor: Grant-Kels Jane
Received: 26 January 2017 / Revised: 28 March 2017 / Accepted: 3 April 2017 / Published: 8 April 2017
(This article belongs to the Special Issue Outstanding Advances in Hemophilia Therapies)
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Abstract

Hip arthropathy in haemophilic patients is disabling for hip and other common target joints. Even if bleedings in the hip are not frequent, femoroacetabular alterations may affect the functional ability of patients at a very young age. A haematologic prophylaxis combined with an adequate lifestyle and regular and low-traumatic physical activity are the keys to preventing such arthropathy. In the early stages of arthropathy, anti-inflammatory drugs and physical therapy may be sufficient to limit its progression. In cases of recurrent symptoms, viscosupplementation with hyaluronic acid, and chemical synoviorthesis are useful options. In more advanced stages, hip arthroscopy may be treated by synovectomy or loose body removal. For late stages, total hip arthroplasty (THA) is mandatory. Until a few decades ago, the clinical outcomes after hip arthroplasty were variable, due to the different management of patients and the use of old generation implants and couplings. In the last decade, the introduction of the multidisciplinary management and the use of modern cementless implants with high performing materials and less invasive surgical techniques have dramatically improved the functional results. Nowadays, as is the case for other target joints, the purpose of the management in haemophilia centers is the early detection of any hip alterations—by clinical and ultrasound (US) evaluations of patients in childhood—to reveal any early articular damage and to provide adequate treatment in case of symptoms. The present paper represents an updated review of the several approaches to hip arthropathy in haemophilia. View Full-Text
Keywords: physical therapy; viscosupplementation; synoviorthesis; total hip artrhoplasty; haemophilia; hip; ceramics; ceramic on polyethylene coupling; cementless arthroplasty physical therapy; viscosupplementation; synoviorthesis; total hip artrhoplasty; haemophilia; hip; ceramics; ceramic on polyethylene coupling; cementless arthroplasty
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This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Carulli, C.; Rizzo, A.R.; Innocenti, M. Hip Arthropathy in Haemophilia. J. Clin. Med. 2017, 6, 44.

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