title: Radiosynovectomy in haemophilic synovitis of elbows and ankles: Is the effectiveness of yttrium-90 and rhenium-186 different?
abstract: BACKGROUND
  Radiosynovectomy (RS) reduces the number of haemarthroses and the synovial size in chronic haemophilic synovitis. The purpose of this study was to quantitatively compare the effectiveness of two types of RS (yttrium-90 vs. rhenium-186) in terms of the objective improvement of haemarthroses and synovial size.
  
  
  METHODS
  Seventy RSs were performed in 70 joints (44 elbows, 26 ankles) of 70 haemophiliacs diagnosed with chronic synovitis. Yttrium-90 was used in 21 joints and rhenium-186 was used in 49 joints. The mean patient age was 20.61 years.
  
  
  RESULTS
  RS resulted in significant improvement in the three variables studied (six months before RS vs. six months after RS), namely in the number of episodes of haemarthrosis (67.8% improvement); the size of the synovium as measured by means of a clinical scale (43.8% improvement) and imaging techniques in millimetres (26.7% improvement). We did not find significant statistical differences between yttrium-90 and rhenium-186 regarding their efficacy. No correlation was found between the results and other variables: age, joint (ankle or elbow), presence or absence of radiological involvement, type of haemophilia (A or B), grade of haemophilia (mild, moderate or severe), previous haematological treatment (on demand or prophylaxis), and the presence or absence of inhibitor
  
  
  CONCLUSIONS
  Yttrium-90 RS and rhenium-186 RS were equally effective in reducing the number of haemarthroses and the size of the synovium in ankles and elbows in the short-term (6 months). No correlation was found between the results and other patients' characteristics.
authors.affiliation: Department of Orthopaedic Surgery, La Paz University Hospital, Madrid, Spain. Electronic address: ecrmerchan@gmx.es.
authors.forename: E C
authors.initials: EC
authors.lastname: Rodriguez-Merchan
authors.affiliation: Department of Rehabilitation and Physical Therapy, La Paz University Hospital, Madrid, Spain.
authors.forename: H
authors.initials: H
authors.lastname: De La Corte-Rodriguez
mesh_terms: D000293:Adolescent; D000328:Adult; D000842:Ankle / Q000473:pathology; D002648:Child; D002908:Chronic Disease; D004551:Elbow Joint / Q000473:pathology; D005260:Female; D006395:Hemarthrosis / Q000209:etiology / Q000628:therapy*; D006467:Hemophilia A / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011868:Radioisotopes / Q000627:therapeutic use*; D012211:Rhenium / Q000627:therapeutic use*; D013585:Synovitis / Q000209:etiology / Q000628:therapy*; D055815:Young Adult; D015021:Yttrium Radioisotopes / Q000627:therapeutic use*
chemical_list: D011868:Radioisotopes; D015021:Yttrium Radioisotopes; D012211:Rhenium
keywords: Ankles; Efficacy; Elbows; Haemophilia; Radiosynovectomy; Synovitis