The impact of platelet-rich plasma on chronic synovitis in hemophilia.

Untreated chronic haemophiliac synovitis leads to the development of haemophilic arthropathy (HA) by affecting the metabolism of chondrocytes. Symptoms are progressive and often surgical intervention is required to prevent total loss of joint function. The focus of our study was to influence the chronic haemophiliac synovitis by means of autologous platelet-rich plasma (PRP) injection. Six patients with hemophilia (PWH), aged between 9 and 45 and manifesting chronic synovitis of the ankle joint on one or on both sides (8 joints in total) were included into the PRP-study. The patients were classified depending on their joint status using the Hemophilia Joint Health Score (HJHS) prior to and again two months after treatment. Three to five ml of PRP was injected into the joint cavity within 30 seconds. In all of the tested PWH pain relief has been reported subjectively by means of the HJHS and VAS scoring systems, comparing the pain intensity before PRP injection and two months after. The difference of pain perception has been found statistically significant for the VAS-scores. Considering the objective synovitis signs shown on MRI before and after PRP injection we recorded a decrease in the volume of free synovial fluid after PRP. All of the tested patients reported benefit of the PRP therapy.