Semin Thromb Hemost 2003; 29(1): 097-100
DOI: 10.1055/s-2003-37943
Copyright © 2003 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Radionuclide Synovectomy (Radiosynoviorthesis) in Hemophilia: A Very Efficient and Single Procedure

E. Carlos Rodriguez-Merchan
  • Consultant Orthopedic Surgeon, Service of Traumatology and Orthopedic Surgery and Hemophilia Center, La Paz University Hospital, Madrid, Spain
Further Information

Publication History

Publication Date:
17 March 2003 (online)

ABSTRACT

Radionuclide synovectomy, so-called radioactive synoviorthesis, is easy to perform and a not very expensive procedure (for example, $150 US for an adult knee). Moreover, it is very efficient in diminishing the frequency and intensity of recurrent hemarthrosis related to chronic hypertrophic hemophilic synovitis. It should be performed as soon as possible in order to try to halt the long-term damage that intra-articular blood will produce in the involved joint. Personal experience and the general recommendation among orthopedic surgeons and hematologists is that when three early consecutive synoviortheses (repeated every 3 months) fail to halt synovitis, a surgical synovectomy (open or by arthroscopy) should be immediately considered.

REFERENCES

  • 1 Ahlberg Å. Radioactive gold in the treatment of chronic synovial effusion in hemophilia. In: Ala F, Denson KWE, eds. Proceedings of the 7th Congress of the World Federation of Hemophilia Amsterdam: Excerpta Medica 1971: 212-215
  • 2 Rodriguez-Merchan E C, Goddard N J. Chronic haemophilic synovitis. In: Rodriguez-Merchan EC, Goddard NJ, Lee CA, eds. Musculoskeletal Aspects of Haemophilia Oxford: Blackwell 2000 0: 43-49
  • 3 Eickhoff H H, Raderschadt G, Koch W, Brackmann H H. Control of the synovium in haemophilia.  Haemophilia . 1998;  4 511-513
  • 4 Rodriguez-Merchan E C, Magallon M, Galindo E, Lopez-Cabarcos C. Hemophilic synovitis of the knee and the elbow.  Clin Orthop . 1997;  343 47-53
  • 5 Lofqvist T, Petersson C, Nilsson I M. Radioactive synoviorthesis in patients with hemophilia with factor inhibitor.  Clin Orthop . 1997;  343 37-41
  • 6 Nuss R, Kilcoyne R F, Rivard G E, Murphy J. Late clinical, plain X-ray and magnetic resonance imaging findings in haemophilic joints treated with radiosynoviorthesis.  Haemophilia . 2000;  6 658-663
  • 7 Heim M, Goshen E, Amit Y, Martinowitz U. Sinoviortesis with radioactive Yttrium in haemophilia: Israel experience.  Haemophilia . 2001;  7(Suppl 2) 36-39
  • 8 Rodriguez-Merchan E C, Jimenez-Yuste V, Villar A. et al . Yttrium-90 synoviorthesis for chronic haemophilic synovitis: Madrid experience.  Haemophilia . 2001;  7(Suppl 2) 34-35
  • 9 Silva M, Luck Jr V J, Siegel M E. 32P chromic phosphate radiosynovectomy for chronic haemophilic synovitis.  Haemophilia . 2001;  7(Suppl 2) 40-49
  • 10 Fernandez-Palazzi F, Rivas S, Cibeira J L, Dib O, Viso R. Radioactive synoviorthesis in hemophilic hemarthrosis: materials, techniques, and dangers.  Clin Orthop . 1996;  328 14-18
  • 11 Rodriguez-Merchan E C, Wiedel J D. General principles and indications of synoviorthesis (medial synovectomy) in haemophilia.  Haemophilia . 2001;  7(Suppl 2) 6-10
  • 12 Rodriguez-Merchan E C. Methods to treat chronic haemophilic synovitis.  Haemophilia . 2001;  7 1-5
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