How Haemophilia Patients Suffer From Joint Bleeds: Know From A Doctor

For individuals living with haemophilia, life is often complicated by more than just the occasional bruise or nosebleed. One of the most debilitating complications they face is recurrent joint bleeding, medically known as haemarthrosis. This painful condition occurs due to the deficiency of essential clotting factors, mainly Factor VIII or IX, which makes it difficult for blood to clot properly. As a result, even minor injuries or daily movements can cause spontaneous bleeding into joints like the knees, elbows or ankles. These bleeds, though internal, lead to swelling, warmth and intense pain, slowly damaging the joint structure and severely restricting mobility over time.

Repeated joint bleeds trigger inflammation of the synovium, the delicate tissue lining the joint, setting off a vicious cycle of bleeding and tissue damage. If left untreated, this can progress to chronic joint disease, known as haemophilic arthropathy, ultimately causing permanent disability. However, with timely diagnosis, factor replacement therapy, and supportive care including physiotherapy, this progression can be prevented. In conversation with The Daily Jagran, Dr Sandeep Abhijit Pattnaik, Consultant, Clinical Haematologist and Bone Marrow Transplant, Manipal Hospital Bhubaneswar, explains how joint bleeds develop in haemophilia patients, what symptoms to watch for, and the latest treatment options that can help improve quality of life and preserve joint function.

Haemophilia is an inherited bleeding disorder due to a lack of production of Factors (mostly VIII and IX) in the human body, and also due to production of inhibitors against the same, mostly affecting men. Dr Sandeep Abhijit Pattnaik, states, “As a result, there is a high tendency of bleeding at joints which constantly bear the weight of the body and are in regular movement, like the knee joints or the elbow joints.”

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Under normal circumstances, these joints are covered by a layer of tissue called the synovium.” When bleeding happens due to trivial trauma, pressure or spontaneously into these joints, there is some amount of synovial inflammation caused by the hematoma (blood clot). That triggers another round of bleeding and gradually, there is a vicious cycle of bleed-synovial damage till the bleed overpowers the protective mechanism. Dr Sandeep Abhijit Pattnaik, explains “As a result of repeated bleeds, the patient experiences pain, and because of hematoma and pain together, his joint movements slowly become restricted. Once that happens, the muscles associated with the joints become weak due to lack of movement and the power of the affected limb further decreases.”

Haemophilia Leads To Joint Bleeding (Image Credits: Canva)

So, is there a way out to deal with this precarious situation? Yes, there is! Dr Sandeep Abhijit Pattnaik states, “Haemophilia is treated with recombinant and plasma-derived Factors (VIII and IX).” These factors can be given in acute onset bleeds, as well as prophylaxis to prevent further bleeds. Hemophilic patients undergoing surgery can be provided factor support both prior to and after surgery. Each of these factors has a weight-based calculation and a schedule, which needs to be strictly complied with to get the desired results. There is availability of inhibitor-bypassing agents for patients who have developed inhibitors to factors. Prothrombin Complex Contrates and Emicizumab are the other newer therapies which can be of high utility for haemophilia patients. Dr Sandeep Abhijit Pattnaikmentions, “In states like Odisha, the number of haemophilia patients is noticeable, but awareness about the available resources is lacking.”

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This is an appeal to all patients who are experiencing joint bleeds, to look for an early diagnosis, and if proven as Factor VIII, IX or even von-Willebrand Deficiency, they should get themselves consulted with a Clinical Haematologist. Proper prophylaxis prevents most of the recurring joint bleeds and damage. Physiotherapy and guarded exercises help improve quality of life. The haemophilia societies (national and international) are always ready to help the public and private health care centres with factor support.