Knee flexion contracture treated with botulinum toxin type A in patients with haemophilia (PWH)
Introduction Knee flexion contracture (KFC) remains a common complication of haemoarthrosis in children and young adults with haemophilia. If the KFC is not treated properly it produces disability, postural and gait abnormalities. Objective Evaluate the effectiveness of conservative treatment of KFC...
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| Veröffentlicht in: | Haemophilia : the official journal of the World Federation of Hemophilia 2016-01, Vol.22 (1), p.134-141 |
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| container_title | Haemophilia : the official journal of the World Federation of Hemophilia |
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| creator | Daffunchio, C. Caviglia, H. Nassif, J. Morettil, N. Galatro, G. |
| description | Introduction
Knee flexion contracture (KFC) remains a common complication of haemoarthrosis in children and young adults with haemophilia. If the KFC is not treated properly it produces disability, postural and gait abnormalities.
Objective
Evaluate the effectiveness of conservative treatment of KFC with Botulinum toxin type A (BTX‐A) in PWH.
Methods
Seventeen patients were treated, with 21 affected knees. Mean age was 26 years. The mean follow up was 12 months. We evaluated flexion and KFC pretreatment BTX‐A and up to 12 months posttreatment. BTX‐A application was in hamstring and calf muscles. To evaluate the function, a questionnaire about different activities was made, and it was checked 3, 6 and 12 months after BTX‐A. According to the degree of KFC, knees were divided into 3 groups: Group 1: −10° to −30° (n = 10), Group 2: −31° to −45° (n = 6) Group 3: −46° or more (n = 5).
Results
The average KFC improved from −38° to −24°. The improvement was 14° (P |
| doi_str_mv | 10.1111/hae.12745 |
| format | Article |
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Knee flexion contracture (KFC) remains a common complication of haemoarthrosis in children and young adults with haemophilia. If the KFC is not treated properly it produces disability, postural and gait abnormalities.
Objective
Evaluate the effectiveness of conservative treatment of KFC with Botulinum toxin type A (BTX‐A) in PWH.
Methods
Seventeen patients were treated, with 21 affected knees. Mean age was 26 years. The mean follow up was 12 months. We evaluated flexion and KFC pretreatment BTX‐A and up to 12 months posttreatment. BTX‐A application was in hamstring and calf muscles. To evaluate the function, a questionnaire about different activities was made, and it was checked 3, 6 and 12 months after BTX‐A. According to the degree of KFC, knees were divided into 3 groups: Group 1: −10° to −30° (n = 10), Group 2: −31° to −45° (n = 6) Group 3: −46° or more (n = 5).
Results
The average KFC improved from −38° to −24°. The improvement was 14° (P < 0.001). The average KFC improvement was 9° in group 1, 17° in group 2, and 23° in group 3. There was a high correlation between the improvement in KFC and the total score of the questionnaire R = 0.77.
Conclusions
Treatment of KFC with BTX‐A improves knee‐related functional activities, with the advantage of being a low‐cost procedure and easy to apply.</description><identifier>ISSN: 1351-8216</identifier><identifier>EISSN: 1365-2516</identifier><identifier>DOI: 10.1111/hae.12745</identifier><identifier>PMID: 26812145</identifier><language>eng</language><publisher>England: Blackwell Publishing Ltd</publisher><subject>Adolescent ; Adult ; botulinum toxin type A ; Botulinum Toxins, Type A - pharmacology ; Botulinum Toxins, Type A - therapeutic use ; Child ; Contracture - complications ; Contracture - drug therapy ; Contracture - physiopathology ; haemophilia ; Hemophilia A - complications ; Humans ; knee flexion contracture ; Knee Joint - drug effects ; Knee Joint - physiopathology ; Middle Aged ; Range of Motion, Articular - drug effects ; Recovery of Function - drug effects ; Surveys and Questionnaires ; Young Adult</subject><ispartof>Haemophilia : the official journal of the World Federation of Hemophilia, 2016-01, Vol.22 (1), p.134-141</ispartof><rights>2015 John Wiley & Sons Ltd</rights><rights>2015 John Wiley & Sons Ltd.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c4665-4a26fe57fcd67e64e168989ee37e402be81fd3781f3a647ac6a54fbc8453ca0b3</citedby><cites>FETCH-LOGICAL-c4665-4a26fe57fcd67e64e168989ee37e402be81fd3781f3a647ac6a54fbc8453ca0b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fhae.12745$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fhae.12745$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,778,782,1414,27907,27908,45557,45558</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26812145$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Daffunchio, C.</creatorcontrib><creatorcontrib>Caviglia, H.</creatorcontrib><creatorcontrib>Nassif, J.</creatorcontrib><creatorcontrib>Morettil, N.</creatorcontrib><creatorcontrib>Galatro, G.</creatorcontrib><title>Knee flexion contracture treated with botulinum toxin type A in patients with haemophilia (PWH)</title><title>Haemophilia : the official journal of the World Federation of Hemophilia</title><addtitle>Haemophilia</addtitle><description>Introduction
Knee flexion contracture (KFC) remains a common complication of haemoarthrosis in children and young adults with haemophilia. If the KFC is not treated properly it produces disability, postural and gait abnormalities.
Objective
Evaluate the effectiveness of conservative treatment of KFC with Botulinum toxin type A (BTX‐A) in PWH.
Methods
Seventeen patients were treated, with 21 affected knees. Mean age was 26 years. The mean follow up was 12 months. We evaluated flexion and KFC pretreatment BTX‐A and up to 12 months posttreatment. BTX‐A application was in hamstring and calf muscles. To evaluate the function, a questionnaire about different activities was made, and it was checked 3, 6 and 12 months after BTX‐A. According to the degree of KFC, knees were divided into 3 groups: Group 1: −10° to −30° (n = 10), Group 2: −31° to −45° (n = 6) Group 3: −46° or more (n = 5).
Results
The average KFC improved from −38° to −24°. The improvement was 14° (P < 0.001). The average KFC improvement was 9° in group 1, 17° in group 2, and 23° in group 3. There was a high correlation between the improvement in KFC and the total score of the questionnaire R = 0.77.
Conclusions
Treatment of KFC with BTX‐A improves knee‐related functional activities, with the advantage of being a low‐cost procedure and easy to apply.</description><subject>Adolescent</subject><subject>Adult</subject><subject>botulinum toxin type A</subject><subject>Botulinum Toxins, Type A - pharmacology</subject><subject>Botulinum Toxins, Type A - therapeutic use</subject><subject>Child</subject><subject>Contracture - complications</subject><subject>Contracture - drug therapy</subject><subject>Contracture - physiopathology</subject><subject>haemophilia</subject><subject>Hemophilia A - complications</subject><subject>Humans</subject><subject>knee flexion contracture</subject><subject>Knee Joint - drug effects</subject><subject>Knee Joint - physiopathology</subject><subject>Middle Aged</subject><subject>Range of Motion, Articular - drug effects</subject><subject>Recovery of Function - drug effects</subject><subject>Surveys and Questionnaires</subject><subject>Young Adult</subject><issn>1351-8216</issn><issn>1365-2516</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkE1PFEEQhjtGI4ge_AOmj3AYmOrPmeMGkSUSNAbDsdPTW5NtnS-7e8Luv7dhgJuxDlV1eOrNWy8hH6E8hVxnW4unwLSQr8ghcCULJkG9ftglFBUDdUDexfirLIGzUr0lB0xVwEDIQ2K-Doi07XDnx4G6cUjBujQHpCmgTbih9z5taTOmufPD3NM07vxA035CuqJ5m2zyOKS4cNlJP05b33lLj7_frU_ekzet7SJ-eJpH5OeXi9vzdXH97fLqfHVdOKGyYWGZalHq1m2URiUQVFVXNSLXKErWYAXthuvcuVVCW6esFG3jKiG5s2XDj8jxojuF8c-MMZneR4ddZwcc52ighrpWgkv1f1QrKCvGdZ3RkwV1YYwxYGum4Hsb9gZK8xC9yQ-bx-gz--lJdm563LyQz1ln4GwB7n2H-38rmfXq4lmyWC58TLh7ubDht1Gaa2nubi7Nur75rOGWmx_8L-BdnAk</recordid><startdate>201601</startdate><enddate>201601</enddate><creator>Daffunchio, C.</creator><creator>Caviglia, H.</creator><creator>Nassif, J.</creator><creator>Morettil, N.</creator><creator>Galatro, G.</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7U7</scope><scope>C1K</scope></search><sort><creationdate>201601</creationdate><title>Knee flexion contracture treated with botulinum toxin type A in patients with haemophilia (PWH)</title><author>Daffunchio, C. ; Caviglia, H. ; Nassif, J. ; Morettil, N. ; Galatro, G.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c4665-4a26fe57fcd67e64e168989ee37e402be81fd3781f3a647ac6a54fbc8453ca0b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>botulinum toxin type A</topic><topic>Botulinum Toxins, Type A - pharmacology</topic><topic>Botulinum Toxins, Type A - therapeutic use</topic><topic>Child</topic><topic>Contracture - complications</topic><topic>Contracture - drug therapy</topic><topic>Contracture - physiopathology</topic><topic>haemophilia</topic><topic>Hemophilia A - complications</topic><topic>Humans</topic><topic>knee flexion contracture</topic><topic>Knee Joint - drug effects</topic><topic>Knee Joint - physiopathology</topic><topic>Middle Aged</topic><topic>Range of Motion, Articular - drug effects</topic><topic>Recovery of Function - drug effects</topic><topic>Surveys and Questionnaires</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Daffunchio, C.</creatorcontrib><creatorcontrib>Caviglia, H.</creatorcontrib><creatorcontrib>Nassif, J.</creatorcontrib><creatorcontrib>Morettil, N.</creatorcontrib><creatorcontrib>Galatro, G.</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Toxicology Abstracts</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Haemophilia : the official journal of the World Federation of Hemophilia</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Daffunchio, C.</au><au>Caviglia, H.</au><au>Nassif, J.</au><au>Morettil, N.</au><au>Galatro, G.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Knee flexion contracture treated with botulinum toxin type A in patients with haemophilia (PWH)</atitle><jtitle>Haemophilia : the official journal of the World Federation of Hemophilia</jtitle><addtitle>Haemophilia</addtitle><date>2016-01</date><risdate>2016</risdate><volume>22</volume><issue>1</issue><spage>134</spage><epage>141</epage><pages>134-141</pages><issn>1351-8216</issn><eissn>1365-2516</eissn><abstract>Introduction
Knee flexion contracture (KFC) remains a common complication of haemoarthrosis in children and young adults with haemophilia. If the KFC is not treated properly it produces disability, postural and gait abnormalities.
Objective
Evaluate the effectiveness of conservative treatment of KFC with Botulinum toxin type A (BTX‐A) in PWH.
Methods
Seventeen patients were treated, with 21 affected knees. Mean age was 26 years. The mean follow up was 12 months. We evaluated flexion and KFC pretreatment BTX‐A and up to 12 months posttreatment. BTX‐A application was in hamstring and calf muscles. To evaluate the function, a questionnaire about different activities was made, and it was checked 3, 6 and 12 months after BTX‐A. According to the degree of KFC, knees were divided into 3 groups: Group 1: −10° to −30° (n = 10), Group 2: −31° to −45° (n = 6) Group 3: −46° or more (n = 5).
Results
The average KFC improved from −38° to −24°. The improvement was 14° (P < 0.001). The average KFC improvement was 9° in group 1, 17° in group 2, and 23° in group 3. There was a high correlation between the improvement in KFC and the total score of the questionnaire R = 0.77.
Conclusions
Treatment of KFC with BTX‐A improves knee‐related functional activities, with the advantage of being a low‐cost procedure and easy to apply.</abstract><cop>England</cop><pub>Blackwell Publishing Ltd</pub><pmid>26812145</pmid><doi>10.1111/hae.12745</doi><tpages>8</tpages></addata></record> |
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| subjects | Adolescent Adult botulinum toxin type A Botulinum Toxins, Type A - pharmacology Botulinum Toxins, Type A - therapeutic use Child Contracture - complications Contracture - drug therapy Contracture - physiopathology haemophilia Hemophilia A - complications Humans knee flexion contracture Knee Joint - drug effects Knee Joint - physiopathology Middle Aged Range of Motion, Articular - drug effects Recovery of Function - drug effects Surveys and Questionnaires Young Adult |
| title | Knee flexion contracture treated with botulinum toxin type A in patients with haemophilia (PWH) |
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