Phosphate-32 colloid radiosynovectomy in hemophilia: outcome of 125 procedures.
Radiosynovectomy offers a potentially effective, minimally invasive option for patients with chronic hemarthrosis and synovitis. The long-term outcome of patients with hemophilia who were treated with phosphate-32 chromic phosphate radiosynovectomy was evaluated. One hundred twenty-five procedures in 81 patients were done. Two- to 10-year followup by age and joint included joint bleeding and quality-of-life assessment. In addition, a relative cost comparison, scintigraphic imaging, and evaluation of biodistribution of the radionuclide were done. Of 125 procedures, 54% resulted in complete cessation of bleeding into the treated joint after the procedure, and 73% of patients reported improved mobility of the treated joint. Of patients 18 years old and younger, 79% had a greater than 75% reduction in bleeding incidence, and of patients older than 40 years, only 56% had a similar reduction. Seventy-nine percent of patients surveyed had a significant improvement in quality of life attributable to the treated joint. No evidence of significant leakage was observed. Billing records analysis indicated that radiosynovectomy costs less than 5% of surgical synovectomy. Phosphate-32 chromic phosphate radiosynovectomy is a clinically useful, safe, and cost-effective outpatient procedure in the treatment of patients with chronic hemarthrosis and synovitis.
Siegel
H J
HJ
Department of Orthopaedic Surgery, Los Angeles County/USC Medical Center, Los Angeles, CA, USA.
Luck
J V
JV
Siegel
M E
ME
Quinones
C
C
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D017608:Chromium Compounds / Q000627:therapeutic use*; D002908:Chronic Disease; D003102:Colloids; D005260:Female; D006395:Hemarthrosis / Q000503:physiopathology / Q000601:surgery*; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010710:Phosphates / Q000627:therapeutic use*; D011788:Quality of Life; D016059:Range of Motion, Articular; D000074402:Synovectomy; D016896:Treatment Outcome
D017608:Chromium Compounds; D003102:Colloids; D010710:Phosphates; C509369:chromic phosphate