Correlations between hemarthrosis, physical assessments and functionality of upper extremity in hemophilic arthropathy of the elbow

Purpose: The aim of this study was to examine the correlations between hemarthrosis, physical assessments, and functionality of upper extremity in hemophilic arthropathy (HA) of the elbow. Methods: This cross-sectional study includes 17 adolescents and young adults with HA of elbow aged between 12 and 30 years. In this scope 23 elbow joints were evaluated. Number of hemarthrosis in elbow was asked to the patients. Pain level was assessed with the Numerical Pain Scale (NPS), range of motion with universal goniometer, muscle strength with digital dynamometer. Hemophilia Joint Health Score-Elbow Point (HJHS-EP), Hospital for Special Surgery Elbow Scoring System and Quick-Disability of Arm, Shoulder and Hand (Q-DASH) were also used for assessing physical status and functionality of elbow and upper extremity. Results: There were correlations between HJHS-EP and loss of extension (r=0.54, p=0.008) and between activity NPS and pronation/supination angles (r=-0.55, p=0.007 and r=-0.60, p=0.003; respectively). Loss of extension was showed moderate negative correlation with triceps muscle strength (r=-0.53, p=0.01). The Q-DASH was strongly negative correlated with triceps muscle strength and pronation angle (r=-0.58, p=0.004 and r=-0.74, p<0.001; respectively). There was strong positive correlation between number of hemarthrosis and NPS (r=0.56, p=0.005). Conclusion: We thought that extension loss and pronation angle were important variables in the physical examination of the elbow in hemophilic arthropathy and functionality may be increased with improvement of pronation angle and triceps muscle strength also the number of hemarthrosis can be decreased by reducing activity pain.