Manual therapy after knee arthroplasty of the patient with haemophilic arthropathy in hemophilia A case study

Abstract

Introduction: The knee joint is one of the most frequently affected by haemophilic arthropathy, and knee arthroplasty is the treatment used in case of advanced degenerative changes. The aim of this study was to present a comprehensive physiotherapeutic procedure, mainly manual therapy, after knee arthroplasty in a patient with hemophilic arthropathy in haemophilia A. Methods: A 49-year-old man with haemophilic arthropathy (haemophilia A), underwent left knee arthroplasty followed by a 6-week rehabilitation. Physiotherapy includes manual therapy exercises and physical therapy. The evaluation of rehabilitation progress was made using: WOMAC questionnaire, timed up and go test (TUG test), goniometric measurement of the range motion of knee joints, assessment of flexor muscles and extensors muscles of the knee in the Lovett scale, pain assessment on the VAS scale. Results: Increased muscular strength and improved range of motion of knee joints was achieved. The dynamic stability and function were improved (TUG test improved by 35%, and WOMAC scale by 32%). Pain was reduced from 9 to 3 on the VAS scale. An efficient gait was achieved. Therapy was contucted without any complications. Conclusions: Physiotherapy performed in haemophilic patient subjected to knee arthroplasty appears an effective and safe procedure.