Heghine Khachatryan: A Resource-Adapted Approach to Hemophilia Joint Care
Heghine Khachatryan, Editor-in-Chief of Hemostasis Today, Head of Hemophilia and Thrombosis Center at Yeolyan Hematology and Oncology Center, shared a post on LinkedIn:
“Resource Limitations Should Shape the Care Pathway—Not Determine a Patient’s Future Mobility.
The WFH educational workshop in Sri Lanka addressed one of the most urgent challenges in global hemophilia care: how to prevent and manage hemophilic arthropathy in low- and middle-resource settings, where access to factor concentrates, imaging, rehabilitation, and specialized orthopedic services may remain limited.
The central message was both scientific and practical: effective joint care can be developed through a structured, multidisciplinary, and resource-adapted pathway:
- Prevention through individualized prophylaxis and timely treatment of hemarthroses
- Standardized longitudinal assessment using the Hemophilia Joint Health Score (HJHS)
- Early detection of subclinical joint changes with HEAD-US and point-of-care ultrasound, where available
- Targeted physiotherapy, muscle strengthening, proprioceptive training, and functional rehabilitation
- Ultrasound-guided procedures performed by appropriately trained teams
- Chemical or radiosynovectomy for persistent or recurrent synovitis in carefully selected patients
- Timely orthopedic referral for advanced, irreversible arthropathy
Importantly, advanced technology is not the only foundation of high-quality care.
Careful clinical assessment, consistent documentation, patient education, rehabilitation, and multidisciplinary cooperation can already protect joint function and prevent disability.
My deepest gratitude goes to Dr. Assad Haffar, the visionary initiator and organizer of this meeting, for creating such a timely, necessary, and genuinely practice-changing educational program.
His leadership brought together expertise from hematology, physiotherapy, rehabilitation, musculoskeletal ultrasound, synovectomy, and orthopedic care.
Most importantly, the workshop did not stop at describing ideal protocols—it translated evidence into feasible and scalable solutions for countries working with limited resources.
Thank you to the World Federation of Hemophilia, the distinguished faculty, local hosts, and all participating colleagues for transforming international expertise into practical skills that can directly improve patient care.
Every joint preserved means mobility preserved.
Every practical skill transferred means disability potentially prevented.
Every sustainable care pathway brings us closer to true global equity in hemophilia care.”
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