Download PDF
Thromb Haemost 1981; 45(02): 127-129
DOI: 10.1055/s-0038-1650148
Original Article
Schattauer GmbH Stuttgart

Synoviorthesis Versus Synovectomy in the Treatment of Recurrent Haemophilic Haemarthrosis: Long-Term Evaluation

G Gamba
The Department of Clinical Medicine “Adolfo Ferrata”, University of Pavia, Italy, and Haemophilia Center, San Matteo Hospital, Pavia, Italy
,
G Grignani
The Department of Clinical Medicine “Adolfo Ferrata”, University of Pavia, Italy, and Haemophilia Center, San Matteo Hospital, Pavia, Italy
,
E Ascari
*   Department of Medical Pathology, University of Pavia, Italy
› Author Affiliations
Further Information

Publication History

Received 23 July 1980

Accepted 16 January 1981

Publication Date:
05 July 2018 (online)

Also available at
  PDF Download  Permissions and Reprints

Summary

The authors report a long-term evaluation of the effects of chemical and surgical synovectomies performed in two groups of patients which were comparable as regards number of haemarthrosis per year and joint mobility. The results obtained indicated that both synovectomy and synoviorthesis were effective in reducing the bleeding episodes; however, while synovectomy stopped almost completely the recurrence of haemarthrosis, synoviorthesis in 3 patients younger than 12 years did not modify it and in one case it even increased the bleeding tendency.

Moreover, the occurrence of arthritic pain was observed in 6 knees treated by synoviorthesis and only in 3 knees treated by synovectomy. Finally, the joint function was significantly reduced in the synoviorthesis group as compared to the synovectomy group.

In conclusion, synovectomy gave better results than synoviorthesis but the latter treatment has a number of economical and technical advantages and should therefore be considered in patients older than 12 years of age with good joint function and without evident radiological changes, in whom fulldose replacement therapy has had no effect on the recurrence of haemarthrosis.

Keywords

Synoviorthesis - Synovectomy - Haemophilic haemarthrosis
 

  • References

  • 1 Storti E, Ascari E. Surgical and chemical synovectomy. Ann N Y Acad Sci 1975; 240: 316-327
    CrossrefPubMedSearch in Google Scholar
  • 2 Storti E, Ascari E. Long-term evaluation of synovectomy in the treatment of recurrent hemophilic haemarthrosis. In: Brinkhous KM, Hemker C. (Eds): Handbook of hemophilia. Excerpta Medica; Amsterdam: 1975. pag. 735-750
    Search in Google Scholar
  • 3 Storti E, Ascari E, Molinari E, Gamba G, Grignani G. La sinoviectomia nell’artropatia emofilica. Fisiopatologia e clinica. Rec Progr Med 1974; 56: 93-149
    PubMedSearch in Google Scholar
  • 4 Pietrogrande V, Dioguardi N, Mannucci PM. Short-term evaluation of synovectomy in haemophilia. Br Med J 1972; 2: 378-381
    CrossrefPubMedSearch in Google Scholar
  • 5 Schwägerl W, Niessner H, Nowotny C, Thaler E, Lechner K. Synovectomie zur Prophylaxe rezidivierender hämophiler Gelenkblutungen. Dtsch Med Wschr 1976; 101: 738-743
    Thieme ConnectPubMedSearch in Google Scholar
  • 6 Sneppen O, Beck H, Holsteen V. Synovectomy as a prophylactic measure in recurrent haemophilic haemarthrosis. Acta Paediatr Scand 1978; 67: 491-495
    CrossrefPubMedSearch in Google Scholar
  • 7 Duthie RB, Matthews JM, Rizza CR, Steel WM. The management of musculo-skeletal problems in haemophilia. 1. st Ed. Blackwell Scientific Publications; Oxford: 1972. pag. 48
    Search in Google Scholar
  • 8 Zimbler S. Surgery in haemophilia. Thromb Haemost 1977; 38: 337 Abstr XII Congr World Fed Hemoph Paris 22-27 June 1977
    PubMedSearch in Google Scholar
  • 9 Bennets GA, Myers MG, Ewald BA. Elective synovectomy in hemophilia. Thromb Haemostas 1977; 38: 372 Abstr XII Congr World Fed Hemoph Paris 22-27 June 1977
    PubMedSearch in Google Scholar
  • 10 Melanotte PL. La sinoviectomia nell’emofilia. Relazione al LXIII Congr SIOT. Palermo 23-26 11/1978; pag. 171-182
    PubMedSearch in Google Scholar
  • 11 Arnold WD, Hilgartner MW. Haemophilic arthropathy. Current concepts of pathogenesis and management. J Bone Joint Surg 1977; 59: 287-305
    CrossrefPubMedSearch in Google Scholar
  • 12 Ahlberg A. Sinoviorthese avec l’or radioactif dans l’hémophilie. Rev Rhum 1977; 44: 41-44
    PubMedSearch in Google Scholar
  • 13 Darracott J, Cole FM, Belbeck L. Chemical synovectomy in induced hemophilic synovitis. Thromb Haemost 1977; 38: 353 Abstr XII Congr World Fed Hemoph Paris 22-27 June 1977
    PubMedSearch in Google Scholar
  • 14 Menkes CJ, Allain JP, Gentil C, Witvoet J, Tak-Tak H, Simon F, Delbarre F. La synoviorthese à l’acide osmique chez l’hémophile. Rev Rhum 1973; 40: 255-258
    PubMedSearch in Google Scholar
  • 15 Berglöf FE. Osmic acid in arthritis therapy. Acta Rheum Scand 1959; 5: 70-74
    PubMedSearch in Google Scholar
  • 16 De Palma AF. Haemophilic Arthropathy. Clin Orthop 1967; 52: 145-165
    CrossrefPubMedSearch in Google Scholar
  • 17 Boni M, Ceciliani L. La sinoviectomia del ginocchio. Relaz LVII Congr SIOT. Bologna 1972; pag. 69-149
    PubMedSearch in Google Scholar
  • 18 Menkes CJ, Piatier-Piketty D, Zucman J, Delbarre T. Effect des injections articulaires d’acide osmique chez le lapin. Repercussion sur la croissance osseuse. Rev Rhum 1972; 39: 513-521
    PubMedSearch in Google Scholar
  • 19 Martio J, Isomaki H, Heikkola T, Laine V. The effect of intraarticular osmic acid on rheumatoid knee joint affections. Scand J Rheum 1972; 1: 5-8
    CrossrefPubMedSearch in Google Scholar
  • 20 Hofmann P, Rössler H, Brackmann HH. Orthopädische Probleme bei der Hämophilie (Pathophysiologie und Ergebnisse operativer Maβnahmen). 1977; 115: 342-355
    PubMedSearch in Google Scholar
  • 21 Lesesne HE, Morgan JE, Blatt PM, Webster WP, Roberts HR. Liver biopsy in hemophilia A. Ann Int Med 1977; 86: 703-707
    CrossrefPubMedSearch in Google Scholar
  • 22 Preston FE, Triger DR, Underwood J CE, Bardhan G, Mitchell VE, Stewart RM, Blackburn EK. Percutaneous liver biopsy and chronic liver disease in haemophiliacs. Lancet 1978; 2: 592-594
    PubMedSearch in Google Scholar
  • 23 Schmipf K, Zimmermann K, Rüdel J, Thamer G, Zaltsch P. Results of liver biopsies, rate of icteric hepatitis, and frequency of anti-Hbs and Hbs-antigen in patients of the Heidelberg hemophilia center. Thromb Haemostas 1977; 38: 340 Abstr XII Congr World Fed Hemoph Paris 22-27 June 1977
    PubMedSearch in Google Scholar
  • 24 Spero JA, Lewis JH, van Thiel DH, Hasiba V, Rabin BS. Asymptomatic structural liver disease in hemophilia. New Engl J Med 1978; 298: 1373-1383
    CrossrefPubMedSearch in Google Scholar