The Application of Focused Medium-Energy Extracorporeal Shockwave Therapy in Hemophilic A Arthropathy

Wan Shan Lo, Jiunn Ming Sheen, Yu Chieh Chen, Kuan Ting Wu, Lin Yi Wang, Yiu Chung Lau, Chih Cheng Hsiao*, Jih Yang Ko*

*Corresponding author for this work

Research output: Contribution to journalJournal Article peer-review


Hemophilic arthropathy causes the damage of synovium, cartilage, and subchondral bone. The present study evaluated the safety and the effect of extracorporeal shockwave therapy (ESWT), a safe treatment widely used in musculoskeletal conditions in patients with hemophilic arthropathy. Between 1 August 2019 and 31 July 2020, seven hemophilia A patients were enrolled and treated with medium-energy ESWT on the knee joint in the first two months after prophylactic coagulation factor administration. At the beginning of the study and at 1-, 2-, 3-, and 6-month followups, the Hemophilia Joint Health Score (HJHS), visual analog scale score (VAS), and Hemophilia Early Arthropathy Detection with Ultrasound score (HEAD-US) were evaluated for therapeutic effectiveness and safety, while serum bone morphogenetic protein 2 (BMP-2) and von Willebrand factor (vWF) levels were analyzed for assessing chondroprotection and bone healing. Magnetic resonance imaging (MRI) of the knee was performed at the beginning of the study and the 6-month follow-ups. As a result, a non-significant decrease in VAS scores (p = 0.151) but not HJHS after treatment was noticed. At the 3-month follow-up, there was a non-significant increase in BMP2 levels (p = 0.171) but not vWF. Ultrasonography showed no disease activity score elevation in five patients and no further disease damage in all patients. Repeated MRI examinations in three patients showed no structural progression during the 6-month follow-up. As to adverse events, redness, local heat, and mild swelling were noted in five patients without breakthrough bleeding. We concluded that medium-energy ESWT might be safe for hemophilic arthropathy once prophylactic coagulation factors are administered.

Original languageEnglish
Article number352
JournalHealthcare (Switzerland)
Issue number2
StatePublished - 02 2022

Bibliographical note

Publisher Copyright:
© 2022 by the authors. Licensee MDPI, Basel, Switzerland.


  • Extracorporeal shockwave therapy
  • Hemophilic arthropathy


Dive into the research topics of 'The Application of Focused Medium-Energy Extracorporeal Shockwave Therapy in Hemophilic A Arthropathy'. Together they form a unique fingerprint.

Cite this