The Effect of Radiation Therapy on Hemophilic Arthropathy

Purpose: Repetitive bleeding into the joint space is the cause of debilitative hemophilic arthropathy. To interrupt this process, we treated the hemophilic patients suffering from repetitive joint bleeding with radiation therapy. Materials and Methods: From 1997 to 2001, a total of 41 joints from 37 hemophilic arthropathy patients were treated with radiation therapy at Kyung Hee University Hospital. The treated joints were 35 ankles, 3 knees and 3 elbows, respectively. The age of the patients ranged from 4 to 27 years (median age: 11 years). The radiation dose ranged from 900 cGy to 2360 cGy (median dose: 900cGy). The fraction size was 150 cGy, 180 cGy or 200 cGy. The number of bleeding in one year before and after radiotherapy was compared. Results: There was a tendency of frequent bleeding for the patients younger than 11 (p = 0.051) but there was also a tendency for more improvement in this group (p = 0.057). The number of joint bleedings was related with joint pain (p = 0.012) and joint swelling (p = 0.033) but not with the Arbold-Hilgartner stage (p = 0.739), cartilage destruction (p = 0.718) and synovial hypertrophy (p = 0.079). The number of bleeding was reduced in thirty-three cases, and eight cases showed no improvement after radiation therapy. The average number of bleeding in a month was 2.52 before radiotherapy, but this was reduced to 1.4 after radiotherapy (p = 0.017). Conclusion: Radiation therapy was effective for the hemophilia patients with repetitive joint bleeding to decrease the bleeding frequency and to prevent hemophilic arthropathy.