This cartilage gets eaten way by enzymes from the swollen synovium. The other type of cartilage, like a shock absorber, is only found in the knees, and is often injured in sports. It is not so important in hemophilic joint damage. In this way, the joint bleeding becomes a vicious circle. As the joint is damaged, bleeding happens more often.
Damage gets worse and worse.
As well as damage to the joint itself, there is often shrinkage of the soft tissues, tendons and ligaments around the joint so that the person loses some of the range of movement in the joint. Almost all severe adult hemophiliacs in Canada suffer from arthropathy in one or more joints. Many have arthropathies in knees, ankles and elbows. The older the hemophiliac, the greater the chance he suffers from multiple severe arthropathies. This is because hemophilia treatment was less advanced when these adults were children - the joint damage began then.