[Evaluation of synovectomy in hemophilic arthropathy follow-up of 26 cases].
Thirty-five joint synovectomies performed between 1973 and 1986 in 26 patients with hemophilic arthropathy at the Department of orthopaedics, University of Colorado Health Sciences Center (UCHSC), USA, were reviewed. There were 15 knees, 15 elbows, 3 ankles and 2 shoulders. Arthroscopic synovectomy was performed on 8 knees. The remaining 27 synovectomies were performed by open surgical synovectomy. Twenty-one (60%) of the 35 joints have had no recurrent hemarthrosis reported, in 14 (40%) there were occasional episodes of bleeding. Among 9 (60%) of the 15 knees and 9 (60%) of the 15 elbows, no further hemarthrosis was observed; 6 (40%) of the knees and 6 (40%) of the elbows reported occasional bleeding episodes. After synovectomy the range of motion improved in 6 (17.2%), 11 (31.4%) remained unchanged and 18 (51.4%) demonstrated decrease. Five joints lost 5 to 10 degrees, 4 joints lost 10 to 20 degrees and 9 joints lost more than 20 degrees. In the group of arthroscopic knee synovectomy the average of motion loss was 20 degrees while in the open surgical knee synovectomy the average motion loss was 38 degrees. After synovectomy the possibility of recurrent hemarthrosis would be 50% and three years later it would be decreased to 31.6%. This review demonstrated that synovectomy was an effective treatment and the decreased degree of the motion after arthroscopy was less than that of open surgery.
Memorial Hospital, Sun Yat-sen, University of Medical Sciences, Guangzhou.
G Z
GZ
Zheng
D000293:Adolescent; D000328:Adult; D002648:Child; D004551:Elbow Joint / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006395:Hemarthrosis / Q000209:etiology / Q000601:surgery*; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D007719:Knee Joint / Q000601:surgery; D008297:Male; D000074402:Synovectomy