title: Safety and efficacy of three arthroscopic procedures using Holmium: Yag laser in two high-responder haemophiliacs.
abstract: We report here on the efficacy and safety of three arthroscopic procedures using a Holmium: Yag laser in two high-responder haemophiliacs. The two patients were treated with an activated prothrombin complex concentrate (FEIBA; Immuno, Vienna, Austria). Treatment was started just before surgery and continued for 4-8 days. On one occasion antifibrinolytics were concomitantly used without thromboembolic complication. Post-operative blood loss was slight, joint mobility was rapidly acceptable and full weight bearing without pain was possible on day 4. Such a procedure would appear to be superior to conventional arthroscopic synovectomy utilizing mechanical devices in haemophiliacs, because it might improve the quality of local haemostasis and the rapidity of post-operative recovery. In addition, it is also the technical procedure of choice in haemophilic patients with inhibitors who need synovectomy.
authors.affiliation: Haemophilia Comprehensive Care Center, Hopital Edouard Herriot, Lyon, France.
authors.forename: C
authors.initials: C
authors.lastname: Ménart
authors.forename: J J
authors.initials: JJ
authors.lastname: Lalain
authors.forename: A
authors.initials: A
authors.lastname: Lienhart
authors.forename: M
authors.initials: M
authors.lastname: Dechavanne
authors.forename: C
authors.initials: C
authors.lastname: Négrier
mesh_terms: D000328:Adult; D001182:Arthroscopy / Q000592:standards*; D001779:Blood Coagulation Factors / Q000008:administration & dosage; D016063:Blood Loss, Surgical / Q000517:prevention & control; D005169:Factor VIII / Q000276:immunology; D006467:Hemophilia A / Q000150:complications / Q000188:drug therapy / Q000601:surgery*; D006695:Holmium; D006801:Humans; D007108:Immune Tolerance; D007518:Isoantibodies / Q000097:blood; D007719:Knee Joint / Q000601:surgery; D053685:Laser Therapy / Q000295:instrumentation / Q000379:methods / Q000592:standards*; D007834:Lasers / Q000592:standards; D008297:Male; D013585:Synovitis / Q000209:etiology / Q000601:surgery
chemical_list: D001779:Blood Coagulation Factors; D007518:Isoantibodies; D005169:Factor VIII; C065655:anti-inhibitor coagulant complex; D006695:Holmium