Long term follow up of haemophilic arthropathy treated by Au-198 radiation synovectomy

Merchan, E. C. Rodríguez; Magallón, M.; Martin‐Villar, J.; Galindo, E.; Ortega, Federico; Pardo, J. A.

doi:10.1007/bf00183554

Cited by 28 publications

(12 citation statements)

References 5 publications

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“…Merchan has previously suggested that a plain radiographic Pettersson score greater than 2 was indicative of a poorer clinical response to radiosynoviorthesis in knees [20]. We did not find this to be true.…”

Section: Discussioncontrasting

confidence: 78%

“…As would be expected, we found no signi®cant differences in the Arnold-Hilgartner or Pettersson scores pre-and 6 months postprocedure (P 0.3750, P 0.6130, respectively). Merchan has previously suggested that a plain radiographic Pettersson score greater than 2 was indicative of a poorer clinical response to radiosynoviorthesis in knees [20]. We did not ®nd this to be true.…”

Section: Discussionmentioning

confidence: 54%

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MRI findings in haemophilic joints treated with radiosynoviorthesis with development of an MRI scale of joint damage

et al. 2000

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We hypothesized that magnetic resonance imaging (MRI) scans taken prior to radiosynoviorthesis may be predictive of response to the procedure in persons with haemophilia. Specifically, response would be inversely related to the severity of synovial hyperplasia. Radiosynoviorthesis was administered to 21 joints with recurrent haemorrhage (target joints). A detailed self-report of haemorrhage history, joint evaluation with scoring according to the World Federation of Haemophilia orthopaedic joint and pain scales, plain radiographs, and MRI studies of the joints were performed pre- and post-radiosynoviorthesis. To augment comparison of the MRI findings to those assessed using the Arnold-Hilgartner and Pettersson scales, a provisional MRI scale for evaluation of haemophilic arthropathy was designed. We found the MRI findings prior to the procedure were not predictive of clinical response; independent of the severity of synovial hyperplasia, most joints bled less and showed improvement by the WFH orthopaedic score. There was generally no change in the severity of synovial hyperplasia after the procedure. We conclude that MRI evaluation is not routinely indicated prior to radiosynoviorthesis.

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Section: Discussioncontrasting

confidence: 78%

Section: Discussionmentioning

confidence: 54%

MRI findings in haemophilic joints treated with radiosynoviorthesis with development of an MRI scale of joint damage

et al. 2000

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“…Joint pain was scored with the World Federation of Haemophilia (WFH) clinical grading [15] (Table 1). Three parameters were considered: (a) pain, (b) functional deficit and (c) use of analgesia.…”

Section: Monitoringmentioning

confidence: 99%

Radionuclide synovectomy and chronic haemophilic synovitis in Asians: a retrospective study

Chew¹,

Tien²,

Sundram³

et al. 2003

Haemophilia

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Radionuclide synovectomy has been identified as the procedure of choice in treating chronic haemophilic synovitis among Caucasian populations. Its effectiveness among East Asians has not been studied. A retrospective study was carried out on 12 Asian haemophiliacs who underwent 12 radionuclide synovectomies. The average follow-up was 30.7 months (range 6-55) for primary procedures. 32P chromic phosphate and 188Re-tin colloid were injected into target joints according to protocol. There was a significant 80% decrease in the median frequency of haemarthrosis from 1.4 per month (range 0.2-7.0) to 0.25 per month (range 0.0-1.8) (P<0.05). Half of the patients had excellent results by 1 year of synovectomy. The median factor usage for target joint haemarthrosis postsynovectomy was 792 units per month (range 0-3209) reduced significantly from a presynovectomy level of 1452 units per month (range 306-7125) (P<0.05). Patients also reported a reduction in joint pain scores, and an improvement in joint mobility and quality of life. The majority of patients were satisfied with the overall outcome of radionuclide synovectomy. Radionuclide synovectomy appears to be effective in reducing the incidence of target joint haemarthrosis and quantity of factor usage for such bleeds among Asians with haemophilic synovitis.

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“…Ahlberg firstly used synoviorthesis with radioactive gold in haemophilic patients in 1971 [8]. Since then, multiple radioisotopes have been used for synoviorthesis purpose in haemophilic patients with promising results [9][10][11][12][13][14][15]. 32 P is an alternative radioisotope, and its use has been approved by the Federal Drug Agency [16].…”

Section: Introductionmentioning

confidence: 99%

³²P colloid radiosynovectomy in treatment of chronic haemophilic synovitis: Iran experience

et al. 2007

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Repeated intra-articular bleeding with subsequent development of chronic synovitis and cartilage changes, leading to haemophilic arthropathy, is one the most debilitating problems in haemophilic patients. Radiosynovectomy is a familiar therapeutic choice in management of chronic synovitis in haemophilia. We report the treatments results of synoviorthesis with (32)P chromic phosphate with emphasis on clinical aspects. Between 2002 and 2006 we performed 66 procedures in 53 patients. Seven patients were excluded. The remaining 46 patients were followed for an average of 31 months. The mean age of patients at the time of injection was 15.9 years (range: 6-28). There were three repeat injections. According to Fernandez-pallazi and Cavilgia clinical classification (Table 1) [23], nine joints were Stage II and 46 were Stage III. In latest follow-up, 77% of patients reported at least a 50% decrease in bleeding frequency after treatment (P < 0.0001). The need for antihaemophilic factor consumption dropped by about 74% postradiosynovectomy (P < 0.0001). In most of the injected joints, the range of motion remained stable or improved. A trend was found for the number of haemarthrosis to increase after a period of considerable improvement. Synoviorthesis using (32)P effectively reduces the intra-articular bleeding rate and factor concentrate use. Durability of the response seems to be unpredictable, perhaps attributable to the late intervention. An early radiosynovectomy might be more helpful in terms of stability of response to treatment.

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Long term follow up of haemophilic arthropathy treated by Au-198 radiation synovectomy

Cited by 28 publications

References 5 publications

MRI findings in haemophilic joints treated with radiosynoviorthesis with development of an MRI scale of joint damage

MRI findings in haemophilic joints treated with radiosynoviorthesis with development of an MRI scale of joint damage

Radionuclide synovectomy and chronic haemophilic synovitis in Asians: a retrospective study

³²P colloid radiosynovectomy in treatment of chronic haemophilic synovitis: Iran experience

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Long term follow up of haemophilic arthropathy treated by Au-198 radiation synovectomy

Cited by 28 publications

References 5 publications

MRI findings in haemophilic joints treated with radiosynoviorthesis with development of an MRI scale of joint damage

MRI findings in haemophilic joints treated with radiosynoviorthesis with development of an MRI scale of joint damage

Radionuclide synovectomy and chronic haemophilic synovitis in Asians: a retrospective study

32P colloid radiosynovectomy in treatment of chronic haemophilic synovitis: Iran experience

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³²P colloid radiosynovectomy in treatment of chronic haemophilic synovitis: Iran experience