Arthroscopic partial anterior synovectomy of the knee on patients with haemophilia

Almeida, Arací Malagodi de; Rezende, Márcia Uchôa de; Cordeiro, Felippi Guizardi; Villaça, Paula Ribeiro; D'Ámico, Elbio Antônio; Hernandez, Arnaldo José; Camanho, Gilberto Luís

doi:10.1007/s00167-013-2706-6

Cited by 10 publications

(3 citation statements)

References 29 publications

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“…Arthroscopic synovectomy, performed as a second option to the non-availability of radioisotope to synoviorthesis, improves parameters of physical and mental quality of life. 18 This improvement obtained by arthroscopic synovectomy can be reproduced by the minor washing out procedure and infiltration with triamcinolone and hyaluronic acid, 6 primarily because we approached with this technique patients with more than one affected joint and a single procedure can improve the function of all, and by what was observed, for over a year.…”

Section: Discussionmentioning

confidence: 93%

Subjective results of joint lavage and viscosupplementation in hemophilic arthropathy

et al. 2015

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OBJECTIVE: To assess whether joint lavage, viscosupplementation and triamcinolone improve joint pain, function and quality of life in patients with severe hemophilic arthropathy. METHODS: Fourteen patients with knee and/or ankle hemophilic arthritis with and without involvement of other joints underwent joint lavage and subsequent injection of hylan G-F20 and triamcinolone in all affected joints. The patients answered algo-functional questionnaires (Lequesne and WOMAC), visual analog scale for pain (VAS) and SF-36 preoperatively, and at one, three, six and twelve months postoperatively. RESULTS: Sixteen knees, 15 ankles, 8 elbows and one shoulder were treated in 14 patients. Six patients had musculoskeletal bleeding [ankle (1), leg muscle (2) and knees (4)] at 3 months affecting the results. Pain did not improve significantly. Function improved (WOMAC p=0.02 and Lequesne p=0.01). The physical component of SF-36 improved at all time points except at 3 months, with best results at one-year follow-up (baseline = 33.4; 1 month = 39.6; 3 months= 37.6; 6 months 39.6 and 1 year = 44.6; p < 0.001). CONCLUSION: Joint lavage followed by injection of triamcinolone and hylan G-F20 improves function and quality of life progressively up to a year, even in severe hemophilic arthropathy. Level of Evidence IV, Case Series.

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Section: Discussionmentioning

confidence: 93%

Subjective results of joint lavage and viscosupplementation in hemophilic arthropathy

et al. 2015

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“…There is now good evidence that synovectomy is an effective procedure for the prevention of recurrent hemarthroses in hemophilia although there is little evidence that it prevents the development of secondary arthritis 14 . This latter point is surprising: whilst it might be expected to slow the development of degenerative change by limiting the exposure of the joint to the high levels of hemosiderin which are thought to be the cause of degenerative change in hemophilia, all series show the development of degenerative change in spite of synovectomy.…”

Section: Synovectomymentioning

confidence: 99%

Evidence-Based Management of the Knee in Hemophilia

Liddle

Rodríguez-Merchán

2017

JBJS Rev

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➢ Hemophilia is among the commonest bleeding disorders encountered in orthopaedic practice and results from an X-chromosome-linked failure of coagulation factors VIII (hemophilia A) or IX (hemophilia B).➢ Morbidity in hemophilia is a result of repeated hemarthroses, and the aim of orthopaedic management is to prevent these, to treat them promptly, and to address the joint pathology that results.➢ Both radiosynovectomy and arthroscopic synovectomy are effective in reducing the degree of synovitis and the number of hemarthroses, although, to our knowledge, there is little evidence that it prevents progression to end-stage arthritis. There is substantial evidence for the safety and effectiveness of radiosynovectomy, and this is the first line of treatment in our practice.➢ In end-stage disease, total knee arthroplasty is challenging as a result of severe contractures and is associated with a higher rate of complications such as infection (7% compared with 1% to 2% in osteoarthritis) and need for blood transfusions and a higher revision rate than that seen in total knee arthroplasty for osteoarthritis.➢ However, many series of total knee arthroplasty for hemophilia have now been published, and excellent results can be gained in terms of pain relief and quality of life.

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“…This cycle of bleeding and synovial hypertrophy leads to the development of a socalled target joint. 6,7 Severe joint destruction often develops in such joints. Before the ankle joint develops into a destructive joint, radioactive synovectomy is usually performed in European countries and in the USA; however, this treatment is not approved in Japan.…”

Section: Arthroscopic Debridement For Advanced Haemophilic Ankle Arthmentioning

confidence: 99%

Arthroscopic debridement for advanced haemophilic ankle arthropathy

et al. 2017

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Arthroscopic partial anterior synovectomy of the knee on patients with haemophilia

Abstract: Two-portal knee arthroscopic synovectomy was effective at reducing bleeding recurrence and improving knee function and QOL in patients with haemophilia, but did not interrupt the progression of radiographic changes.

Cited by 10 publications

References 29 publications

Subjective results of joint lavage and viscosupplementation in hemophilic arthropathy

Subjective results of joint lavage and viscosupplementation in hemophilic arthropathy

Evidence-Based Management of the Knee in Hemophilia

Arthroscopic debridement for advanced haemophilic ankle arthropathy

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