Controlled trial of joint aspiration in acute haemophilic haemarthrosis.

Twelve severely affected haemophiliacs presenting with 22 acute haemarthroses of the knee were admitted to a trial in which, with their consent, they were treated either by intravenous infusion of human antihaemophilic factor alone or by aspiration of the knee joint in addition. The trial was restricted to patients with haemarthroses of intermediate size, as only in this situation were the indications for aspiration considered doubtful. Thus, patients were excluded if there was insufficient knee swelling to make it likely that blood could be withdrawn, or if aspiration was positively indicated by distension causing continuous pain at rest. By the next day, a significantly greater average range of movement had been regained in the eleven aspirated knees than in the eleven knees not aspirated, although after 5 days the average improvements were nearly equal. In planning treatment of individual cases, this benefit must be set against the painfulness of the procedure.