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Purpose: Various modes of therapy have been directed at breaking the vicious cycle at early stage of synovitis in haemophilia patients. This study was planned to assess the short-term clinico-radiological outcome of chronic knee synovitis among haemophilia A patients post phosphorus-32 (P-32) radiosynoviorthesis. Methods: P-32 samarium radiocolloid was injected into the knee and patients were followed up at 1 and 3 months, respectively. Clinical outcomes was assessed using Tegner Lysholm scores (TLSs), Modified Knee Society Clinical Rating System (MKSS) score and circumference of the knee joint. The radiological outcomes were assessed using X-ray, ultrasonography and bone scan. Results: Among the fifteen haemophilia A patients studied, there was statistically significant difference in TLS (w 2 (2) ¼ 27.887 and p value < 0.001), MKSS scores (w 2 (2) ¼ 27.745 and p < 0.001) and circumference of the knee joint (w 2 (2) ¼ 21.333 and p < 0.001) at preoperatively, 1-and 3-month follow-up. There were no changes noted in follow-up X-rays compared with the preoperative X-ray. Ultrasonography showed that clinical improvement was more in suprapatellar and medial parapatellar regions in the last 2 months compared to the first month of follow-up. Post P-32 bone scan showed marked decrease in uptake in the affected knee joint suggestive of radio ablation of synovial tissue. Conclusion: P-32 radiosynoviorthesis done for chronic synovitis among haemophilia A patients showed significant improvement in both clinical and radiological parameters. Ultrasonography can be utilized as non-invasive radiological modality for follow-up of P32 response for knee joint.

Background and objectives:The forearm represents a critical anatomic unit of the upper limb, permitting the effector organ of the upper limb, the hand, to perform multi axial daily activities of living. Historically, the closed management of forearm fractures has been met with poor functional outcome in adults, hence perfect fracture reduction and rigid fixation is mandatory and achieved by plating. Conservative treatment has resulted in malunion, nonunion, synostosis and ultimately poor functional outcome [1] . Hence the present study was undertaken to provide satisfactory functional outcome and to know the advantage and complications of the newer plate design, the LC-DCP. Materials and methods:The present study was conducted in Department of Orthopaedics at Sri Siddhartha medical college, hospital and Research Center Tumkur during the period from August 2014 and July 2016. A total of 32 patients attending the hospital during the study period with closed diaphyseal fracture of both bones forearm aged more than 18 years who were medically fit for surgery were included in the study. Results: In this study, Males were predominant with left forearm affection more than right. Most of the fractures were due to road traffic accidents and fall. The average age was 33.5 years with fracture being most common in second and third decade. Most of fractures both bones forearm were located in the middle third and the fracture pattern, transverse/short oblique was commonest. 32(100%) Radius and 32(100%) ulna united within 6 months. The results were based on Anderson et al, scoring system and in our study there were 26 (81%) patients with excellent results, 6 (19%) patients with satisfactory results. Conclusion: Our study shows that LC-DCP plating of both bones forearm produces excellent results when applied properly. To obtain excellent results: proper preoperative planning, minimal soft tissue dissection, adherence to AO principles, strict asepsis, proper postoperative rehabilitation and patient education are mandatory

Aim: There are various medical and surgical modalities available at breaking the vicious cycle of synovitis-hemarthrosis-synovitis at an early stage of synovitis in patients of haemophilia. Our study was planned to assess the short term clinical outcome in chronic knee synovitis among haemophilia A patients treated with phosphorus-32 (P-32) radiosynovectomy. Methods: Fifteen haemophilia A patients with chronic knee synovitis were injected with P-32 Samarium radiocolloid into the knees. These patients were clinically assessed at time of injection, at one and at three months post procedure. The parameters evaluated are the Tegner Lysholm Score (TLS), Modified Knee Society Clinical Rating System score (MKSS) and by measuring the circumference of the knee joint pre and post injection. Results: Among the fifteen haemophilia A patients studied, there was statistically significant difference in all three parameters recorded with TLS having χ2 (2) = 27.887 and p value <0.001, MKSS scores having χ2 (2) = 27.745 and p <0.001, and circumference of the knee joint showing χ2 (2) = 21.333 and p <0.001 at the end of one and three months follow up. Conclusion: P-32 radiosynovectomy done for chronic knee synovitis among haemophilia A patients showed significant improvement in clinical parameters. Hence we suggest that this simple procedure may be added to the armamentarium of current options available for these patients.