The effectiveness of radiosynovectomy in chronic hemophilic synovitis

Purpose: The aim of this study was to investigate the effectiveness and safe of radiosynovectomy (RS) in chronic hemophilic synovitis.Material and Method: RS was performed on 35 joints (knee; n:20, elbow; n:11, ankle;n:3) 24 patients suffering from chronic hemophilic synovitis and recurrent hemarthroses. Mean follow-up period after the RS was 14.6 months (range:10-20). Reccurent bleeding can lead to chronic synovitis in hemophilic patients. Radiosynovectomy (RS) is an effective treatment option for chronic hemophilic synovitis. RS of the knee was performed using Y?90, all other joints, were treated with Re?186. In all cases, before and after RS, factor replacement theraphy was given.Before and after RS, hemorrage frequency, severity pain in target joint was asked. Magnetic rezonance imaging (MRI) evaluation of hemophilic arthropathy, joint were scored using `Denver? scoring scheme both prior and following RS. Denver MRI scale includes joint effusion, synovial hyperthrophy, haemosiderin deposition, erosion, cysts and cartilage loss. Also in the 17 of the 24 patients, scintigraphy were performed fort the detection of radyonuclide leakage.Result: Both the frequency of the reccurent intraarticular bleedings and joint pain score were decreased after RS. After a mean observation period of 14,6 months, there were no any joints with worsened Denver score. The differances in the Denver scores fort he elbowand ankle joints was not significant. But fort he knee joints significance was borderline. In the visual evaluation of the 17 patients scinigraphy after the RS.Conclusion: RS with Y?90 and Re?186 was safe and effective in chronic hemophilic synovitis. Our investigation was limited to a small number of knee joints, therefore further studies are needed to confirm our results.