Early Identification and Treatment of Joint Damage

Joint damage cannot be reversed, but there are treatment options that can help keep damage from getting worse. The first step is to recognize joint damage as early as possible so treatment can begin before the damage progresses too far.

Recognizing joint damage
The symptoms of joint damage include pain and decreased range of motion with or without swelling of the joint. However, unlike the swelling that appears during a joint bleed, this swelling won’t go away, even after treatment with clotting Factor.

Early on, the joint may still move without pain. But, over months or years, the joint may become more difficult to move as the damage progresses. This is because the cartilage and bone have become damaged, making the joint difficult to move smoothly. If a joint has become swollen and painful from joint damage, it may become difficult to tell whether the swelling is from a new bleed or resulting from the joint damage itself.

After joint damage has occurred, it is important to aggressively treat the joint to protect it from further damage.

Target Joint with Early Damage An insufficiently treated bleed can result in the development of a “target joint” – one that becomes continuously inflamed and vulnerable to recurrent, spontaneous bleeds. Prophylaxis is required to break the cycle of repeated bleeds and to prevent joint damage. Additional drug therapy and/or surgery may also be necessary.

Target Joint with Damage During a joint bleed, the space around the joint fills with blood. The area may appear swollen, and the joint will become difficult to move. The body produces proteins called enzymes as part of the inflammatory process, but these enzymes may also damage the cartilage and bones. The joint lining swells and continues to be inflamed.

Severe Cartilage Damage Over time and with repeated bleeds, the cartilage erodes significantly, resulting in osteoarthritis. Arthritis is associated with intense pain and a decrease in the joint’s range of motion.

• A period of prophylactic clotting Factor therapy. Prophylaxis may be recommended for a few months to prevent new bleeds and allow the joint to heal.
• Strengthening exercises. Exercise may be used to strengthen the muscles around the affected joint and protect it from further injury.
• Protecting the joint with a splint or brace. In this case, exercises are even more important because using a splint may cause the surrounding muscles to weaken.
• Steroid injections. Given by a doctor who specializes in treating joints, steroid injections can help reduce inflammation in the affected joint.
• Radioactive Synovectomy. A procedure conducted by a doctor, radioactive synovectomy can help reduce inflammation in the joint and reduce the lining of the joint, thereby preventing bleeds in the affected joint.
• Surgery. In some cases, surgery can help alleviate swelling in the tissues surrounding the joint. If joint damage is severe and the joint can no longer be used, joint replacement may be an option.