Synovectomy for haemophilic arthropathy: 6–21 years of follow‐up in 16 patients

Teigland, Jens; Tjønnfjord, Geir E.; Evensen, Stein A.; Charania, B.

doi:10.1111/j.1365-2796.1994.tb01066.x

Cited by 25 publications

(13 citation statements)

References 19 publications

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“…17, 30 Green has shown that motion can be reasonably preserved when children with hemophilia undergo open arthrotomy and synovectomy of the ankle. 17, 30 Green has shown that motion can be reasonably preserved when children with hemophilia undergo open arthrotomy and synovectomy of the ankle.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic Synovectomy for Hemophilic Joint Disease in a Pediatric Population

Dunn¹,

Busch²,

Wyly³

et al. 2004

Journal of Pediatric Orthopaedics

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Children with hemophilia can develop progressive arthropathy. Arthroscopic synovectomy has been used to reduce hemarthroses, but few long-term results have been published. In this article the authors review their first 12 years of experience. Data are reported on 44 pediatric patients (69 joints: 39 ankles, 21 elbows, 7 knees, 2 shoulders). The median age at surgery was 10 years Median follow-up was 79 months. Joints with sufficient follow-up data showed a median bleeding frequency decline of 84% (P < 0.001). Median arc of motion was stable or improved in the year after surgery in ankles, elbows, and shoulders. Complications were rare. Radiographic scores worsened slightly. In this largest analysis of arthroscopic synovectomy for children with hemophilia, rehabilitation was not problematic.

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Section: Discussionmentioning

confidence: 99%

Arthroscopic Synovectomy for Hemophilic Joint Disease in a Pediatric Population

Dunn¹,

Busch²,

Wyly³

et al. 2004

Journal of Pediatric Orthopaedics

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“…Comparisons between the efficacy of open synovectomy and medical synovectomy are hard to make, because of the absence of a comparative study and the small number of patients in each series (24–27). All of the studies reviewed here report on the efficacy of surgery for the reduction of pain and the number of haemarthrosis.…”

Section: Discussionmentioning

confidence: 99%

A retrospective study on chemical and radioactive synovectomy in severe haemophilia patients with recurrent haemarthrosis

Molho¹,

Verrier

Stieltjes³

et al. 1999

Haemophilia

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Between 1970 and 1994, 116 chemical and 90 radioactive synovectomies were performed in 107 patients with severe haemophilia and two with type 3 von Willebrand's disease. The products used were osmic acid (OA) in 100 cases, 90-Yttrium in 35 cases, 186-Rhenium in 48, 169-Erbium in two, hexacetonide triamcinolone in 16 and radioactive gold in five cases. The use of radioactive colloids is not allowed in France in patients under 15 years of age. Twenty-nine patients had more than one synovectomy per joint. All patients were evaluated for 6 months post-synovectomy, using both a clinical and a radiological score. Six months after synovectomy, a good or excellent result was obtained for 81% of the joints treated with isotopes, compared with 44% of those treated with OA, P<0.001. This superiority of isotopes over osmic acid was still observed after 6 months for the 89 joints that were re-evaluated, with follow-up ranging from 1 to 9 years. It was possible to calculate a radiological score in 84 cases. With OA the best results were from the joints with the lowest scores pre-synovectomy (<7). No correlation could be established between the clinical and the radiological scores, due to the small size of the sample. In summary: (1) chemical and radioactive synovectomy are simple and safe procedures for haemophilic arthropathy, (2) in our series, after 6 months the efficacy of isotopic synovectomy was greater than that of chemical synovectomy, and this benefit seems to persist after 6 months, and up to 9 years in the group of patients with longer-term follow-up.

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“…It is important to note that this irradiation is smaller than in diagnosis by conventional bone scintigraphy or whole-body scanning with 67Ga. Considering the local efect at joint level, several studies with long follow-up times have shown no occurrence of tumours [14,26,27], indicating that this possibility has not yet been characterised.…”

Section: Side Efectsmentioning

confidence: 99%

Synovectomy with 153Samarium Hydroxyapatite in Haemophilic Arthropathy

Calegaro¹

2018

Hydroxyapatite - Advances in Composite Nanomaterials, Biomedical Applications and Its Technological Facets

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There are two main types of haemophilia, classiied according to deiciency: type A, caused by factor VIII deiciency; and type B, which is rarer and the result of a deiciency in factor IX. Haemarthroses account for 80% of bleeding in haemophilic patients, with half of these exhibiting deformities. Repeated joint efusion leads to a local inlammatory response, with the formation of hyperplasic and hypertrophic cells and subsequent buildup of haemosiderin. Fibroblasts proliferate and produce collagenases and proteinases that act on the synovium, cartilage and bone, with a decrease in the joint space. Another mechanism involved is the damage caused by direct action of red blood cells on the cartilaginous surface of the joint lining. 153-samarium was obtained in research reactor by neutron irradiation of 152Sm 2 O 3 (99.4%) in the nitrate form, 152Sm(n,p)153Sm, for 30-36 h. The labelling process was performed with 40 mg of hydroxyapatite, according to Barboza et al. Radiochemical purity, particle size, microbiological tests for sterility and pyrogen were the tests applied to obtain an useful material. The introduction of 153Sm-HA for the treatment of haemophilic arthropathy in large and medium joints was a safe, cost-efective, minimally invasive and efective procedure in controlling bleeding and pain.

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Synovectomy for haemophilic arthropathy: 6–21 years of follow‐up in 16 patients

Cited by 25 publications

References 19 publications

Arthroscopic Synovectomy for Hemophilic Joint Disease in a Pediatric Population

Arthroscopic Synovectomy for Hemophilic Joint Disease in a Pediatric Population

A retrospective study on chemical and radioactive synovectomy in severe haemophilia patients with recurrent haemarthrosis

Synovectomy with 153Samarium Hydroxyapatite in Haemophilic Arthropathy

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