Predicting the development of hemophilic arthropathy in patients with hemophilia based on patient age: a retrospective single-center database study

ABSTRACT

Background

Patients with hemophilia (PWH) develop hemophilic arthropathy of the major joints due to recurrent hemarthrosis. This study retrospectively estimated the age at which PWH may expect to develop hemophilic arthropathy and undergo joint replacement surgery.

Research design and methods

Using retrospective data from PWH at a Czech orthopedic center, Kaplan Meier analyses were used to estimate the cumulative proportions of patients with hemophilic arthropathy and undergoing joint replacement surgery as a function of age.

Results

Based on 1028 joint examinations in 167 PWH, hemophilic arthropathy of the knees, elbows, ankles and hips was estimated to develop by a median age of 48, 51, 52 and 61 years, respectively, with ≈80% of patients having such damage by ≈70 years of age. Hemophilic arthropathy of the shoulder occurred much later (median >80 years). In patients undergoing knee or hip replacement surgery, hemophilic arthropathy of the knee and hip occurred at a median age of ≈50 and ≈60 years, respectively, with replacement surgery occurring at a median of ≈70 and >75 years.

Conclusions

In PWH, the risk of developing hemophilic arthropathy accumulates continuously over the patient’s lifetime, allowing predictions about the ages at which such damage and joint replacement surgery may occur.

KEYWORDS:

• Age
• arthroplasty
• hemophilia
• hemophilic arthropathy
• joint alteration
• total endoprosthesis

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Author contributions

All authors have contributed significantly to the conception, design, or acquisition of data, or analysis and interpretation of data. All authors have participated in drafting, reviewing, and/or revising the manuscript and have approved its submission.

Acknowledgments

Editorial assistance was provided by David P. Figgitt PhD, ISMPP CMPP™ and Katherine Lyseng-Williamson on behalf of Content Ed Net, with funding from Novo Nordisk.

Ethics approval and consent to participate

The study has been approved by the Ethics Committee of the University Hospital Bulovka (approval no. 8.7.2022/10513/EK-Z). Due to the retrospective nature of the study, the Ethics Committee of the University Hospital Bulovka has waived informed consent for the study. All methods were carried out in accordance with relevant guidelines and regulations.

Data availability statement

Data are available from the corresponding author upon reasonable request.

Additional information

Funding

Funding for the study was provided by Novo Nordisk.