title: Arthroscopic synovectomy for hemophilic joint disease in a pediatric population.
abstract: Children with hemophilia can develop progressive arthropathy. Arthroscopic synovectomy has been used to reduce hemarthroses, but few long-term results have been published. In this article the authors review their first 12 years of experience. Data are reported on 44 pediatric patients (69 joints: 39 ankles, 21 elbows, 7 knees, 2 shoulders). The median age at surgery was 10 years Median follow-up was 79 months. Joints with sufficient follow-up data showed a median bleeding frequency decline of 84% (P < 0.001). Median arc of motion was stable or improved in the year after surgery in ankles, elbows, and shoulders. Complications were rare. Radiographic scores worsened slightly. In this largest analysis of arthroscopic synovectomy for children with hemophilia, rehabilitation was not problematic.
authors.affiliation: Department of Pediatrics, AFLAC Cancer and Blood Disorders Center at Children's Healthcare of Atlanta/Emory University, Atlanta, Georgia, USA. amy.dunn@choa.org
authors.forename: Amy L
authors.initials: AL
authors.lastname: Dunn
authors.forename: Michael T
authors.initials: MT
authors.lastname: Busch
authors.forename: J Bradley
authors.initials: JB
authors.lastname: Wyly
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Sullivan
authors.forename: Thomas C
authors.initials: TC
authors.lastname: Abshire
mesh_terms: D000293:Adolescent; D000843:Ankle Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D001182:Arthroscopy; D002358:Cartilage, Articular / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D004551:Elbow Joint / Q000000981:diagnostic imaging / Q000601:surgery; D006395:Hemarthrosis / Q000209:etiology / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D006467:Hemophilia A / Q000150:complications; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D011859:Radiography; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D000074402:Synovectomy