الفهرس 
Review of f literature Chapter 1Only 14 pages are availabe for public view
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Abstract
Summary Hemophilic arthropathy (HA) is a debilitating complication of hemophilia mostly occurring in severe types with recurrent spontaneous intra‐articular bleeding. The condition mainly affects youngsters in whom clotting factor supplementation has not been administered from childhood. Knee is the most common joint involved. Recurrent episodes of hemoarthrosis occur in the joints leading to a sequence of iron deposition, synovial inflammation and cartilage degradation.
This chemical process along with mechanical stress leads to a state of hyaline cartilage wear and synovial fibrosis and hypertrophy, which signifies HA. HA of the knee results in deformity, pain and limitation of range of motion and has a major impact in quality of life and functional condition of this young patient group.
Total knee arthroplasty (TKA) is known as the gold standard treatment for end stage hemophilic arthropathy. Due to particular features of these patients compared to primary osteoarthritis of the knee, such as bleeding tendency, younger age, pre-operative restricted range of motion (ROM), altered anatomy, and increased complications.
Pain is the most common indication for total knee arthroplasty. In advanced hemophilic arthropathy of the knee, there is a limitation in joint range of motion and weight bearing can be extremely painful. Treatment of the knee arthropathy depends on the stage of the disease, impact on quality of life, severity of symptoms, previous treatment, and available resources. Surgical procedures such as TKA are reserved for patients in whom conservative methods have already failed.