Subchondral haematoma.

Abstract:

:Haemophilic arthropathy is a complex multifactorial disorder that poses significant challenges to both the treating haematologist and arthroplasty surgeon. Its pathogenesis is incompletely understood. Recent literature has concentrated on the toxic effects of iron and the characteristic inflammatory synovitis. Discussion of the role of subchondral bleeding in joint damage has been neglected. A case of haemophilic arthropathy with extensive evidence of subchondral bleeding and related osteochondral destruction is presented. RESULT:The relevance of this mechanical pathway in the future management of haemophilic arthropathy is discussed with reference to recent literature. CONCLUSION:Clinicians should consider its importance when deciding whether to manage patients expectantly or with prophylactic factor replacement. :Die hämophile Arthropathie ist eine komplexe, multifaktorielle Störung, die sowohl für den behandelnden Hämatologen als auch für den Operateur eine erhebliche Herausforderung darstellt. Die Pathogenese ist noch nicht völlig geklärt. Die aktuelle Literatur konzentriert sich auf die toxische Wirkung von Eisen und die charakteristische Synovitis. Die Rolle der subchondralen Blutung bei der Gelenkschädigung wurde bisher nicht diskutiert. Es wird ein Fall einer hämophilen Arthropathie mit erheblichen Anzeichen für eine subchondrale Blutung und eine entsprechende osteochondrale Schädigung vorgestellt. ERGEBNIS:Die Bedeutung dieses mechanischen Ansatzes bei der zukünftigen Behandlung der hämophilen Arthropathie wird mit Verweis auf die aktuelle Literatur besprochen. SCHLUSSFOLGERUNG:Ärzte sollten diese Bedeutung bei der Entscheidung berücksichtigen, Patienten abwartend oder durch prophylaktische Faktorsubstitution zu behandeln.

journal_name

Hamostaseologie

journal_title

Hamostaseologie

authors

Wharton R,Austin S,Back D

doi

10.5482/HAMO-15-12-0033

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

104-106

issue

2

eissn

0720-9355

issn

2567-5761

journal_volume

37

pub_type

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