Hyaluronic Acid and Chondroitin Sulfate Viscosupplementation in Severe Arthropathy of Hemophilic Patients

Type A hemophilia is a hereditary coagulopathy caused by coagulation factor VIII deficiency, clinically characterized by hemorrhagiparous phenomena of different intensity, depending on disease severity or on the intensity of the injury suffered by the patient. The severe forms of the condition may become complicated by spontaneous sometimes even life-threatening bleeding, in the absence of factor VIII substitution treatment. Considerable bleeding may occur at the intraarticular, intramuscular or mucosa level, whereas life-threatening bleeding may occur anywhere in severe injuries. Two types of hemorrhagiparous are specific to the disease and are also the most common: hemarthroses and hematomas. As far as hemarthroses are concerned, each joint hemorrhage episode causes a topical disorder, which predisposes to recurrence, with the onset over time of the main chronic complication of this condition, hemophilic athropathy, which progresses slowly throughout the patient's life and generates severe sequellae (ankylosis). This paper aims at emphasizing the importance of viscosupplementation by the injection of hyaluronic acid and chondroitin sulfate in the joints of hemophilic patients with severe athropathy, with a view to improving the locomotor function, to reducing the number of bleeding episodes and joint pain.