The efficacy of radiosynoviectomy in hemophilic hemarthrosis according to the frequency of joint bleedings

Full text: Radiosynovectomy is a potentially effective method for treatment of recurrent hemarthrosis in patients with hemophilia, and can prevent the onset of hemophilic arthropathy. Aim: to ascertain the effectiveness of radiosynovectomy in patients suffering from hemophilic hemarthrosis, to determine the effect of treatment on clotting factor consumption, and to find out how the patients experience radiosynovectomy. 26 radiosynovectomies were done in 21 patients. Four joints were treated twice and one patient had 2 joints treated at the same time. 90Y colloid was used for the knee joint (8 joints) and 186Re colloid for ankle, shoulder and elbow radiosynovectomy (18 joints). The patients were followed for one year after therapy using a questionnaire. During the first year following radiosynoviorthesis as compared to the year prior to the therapy the outcome of treatment was excellent in 11%, and good in 42% of cases. The number of hemarthroses fell from 13 ± 8 to 7 ± 6 per year, and the consumption of the clotting factor declined by 13,200 I.U./year on the average. In joints with 12 or more bleedings the number of hemarthroses fell from 21 to 7 on the average. The outcome of treatment was excellent in 25%, and good in 37% of cases. A mean decrease in clotting factor consumption in the group was 25,800 I.U. In joints with less than 12 bleedings, the number of bleeding episodes declined by 1, and the saving effected in the consumption of clotting factor was negligible. After the treatment, 55% of patients had no adverse reactions; 37% had mild transitory swelling and 7% developed moderate transitory swelling of the treated joint. It was concluded that radiosynovectomy is an effective method for the treatment of hemophilic hemarthrosis, particularly in patients with frequent intra-articular bleedings. In patients with frequent bleedings into joints the consumption of the clotting factor was reduced significantly only. Radiosynovectomy is well accepted by patients suffering from hemophilic hemarthrosis. (author)