Open and Arthroscopic Synovectomy in Hemophilic Arthropathy of the Knee

Triantafyllou, Steven J.; Hanks, G.; Handal, John A.; Greer, Robert B.

doi:10.1097/00003086-199210000-00027

Cited by 46 publications

(33 citation statements)

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“…Weidel concluded that arthroscopic synovectomy was effective in reducing recurrent haemarthrosis, and probably slowed, but did not prevent, haemophilic arthropathy. These findings are similar to those reported from other centres on the outcome of arthroscopic synovectomy in haemophilia (Triantafyllou et al, 1992;Eickhoff et al, 1997;Rodriguez-Merchan et al, 1997).…”

Section: Arthroscopic Synovectomysupporting

confidence: 91%

“…Arthroscopic synovectomy for haemophilic arthropathy was first reported at the WFH Congress in 1983 (Kim et al, 1984;Wiedel, 1984). The arthroscopic technique offers clear improvements compared with open synovectomy, including decreased postoperative bleeding, shorter hospitalisation stays, fewer complications and improved ROM (Triantafyllou et al, 1992).…”

Section: Arthroscopic Synovectomymentioning

confidence: 99%

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Modern management of haemophilic arthropathy

2007

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SummaryCurrently available factor concentrates for treatment of patients with haemophilia are virally inactivated or are made by recombinant technology and their broad use in developed nations has resulted in the dramatic elimination of the treatment‐related viral illnesses that decimated the haemophilia community in the late 20th century. The major morbidity experienced by patients with haemophilia today is joint disease, a result of repeated bleeding episodes into joint spaces. Although administration of factor concentrates to prevent bleeding has been demonstrated to prevent haemophilic joint disease when applied assiduously, repeated bleeding episodes induce synovitis that is irreversible and may progress despite subsequent prophylaxis. Surgical and nuclear medicine interventions are available to reduce the pain of haemophilic arthropathy and to reduce further bleeding episodes. Patients with high titre inhibitors are at great risk for the development of joint disease and present the greatest therapeutic challenges when joint surgery is needed.

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Section: Arthroscopic Synovectomysupporting

confidence: 91%

Section: Arthroscopic Synovectomymentioning

confidence: 99%

Modern management of haemophilic arthropathy

2007

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“…But the technical skills required for a complete arthroscopic synovectomy are demanding due to bony abnormalities, disorganised joint, loss of motion and dense intra-articular and synovial fibrosis. In 1992, Triantafyllou et al [17] compared eight open synovectomies of the knee with five arthroscopic synovectomies. The frequency of knee haemarthrosis reduced in both open and arthroscopic synovectomy groups.…”

Section: Discussionmentioning

confidence: 99%

Arthroscopic synovectomy in haemophilic arthropathy of the knee

Yoon

Bae

Kim

et al. 2005

International Orthopaedics (SICOT)

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From January 1996 to January 2001, arthroscopic synovectomies were performed in 28 knees with haemophilic arthropathy. The mean follow-up period was 5 years and 11 months. Six portals (two anterior, two suprapatellar, two posterior) and a posterior trans-septal portal were used in all cases. The average Hospital for Special Surgery (HSS) knee score increased from 56.4 to 71.5 points at the last follow-up. The average frequency of haemarthrosis reduced from five times per month before operation to once per month. The amount of factor replacement decreased from a mean of 4,633 U to 1,505 U. Progression of arthritis was observed radiographically in three cases at the last follow-up. An arthroscopic synovectomy of the knee using appropriate arthroscopic portals is a useful method in treating haemophilic patients as it decreases bleeding episodes, amount of factor replacement and knee pain.Résumé De janvier 1996 à janvier 2001, des synovectomies arthroscopiques ont été exécutées dans 28 genoux avec une arthropathie hémophilique. Le suivi moyen était 5 années et 11 mois. Six abords (deux antérieurs, deux suprarotuliens, deux postérieurs) et un abord trans-septal postér-ieur ont été utilisé dans tous les cas. Le score moyen du genou de l'Hôpital pour Chirurgie Spéciale (HSS) a augmenté de 56,4 à 71,5 points au dernier examen. La fré-quence moyenne d'hémarthrose s'est réduite de cinq fois par mois avant l'opération à une fois par mois aprés. La quantité moyenne de remplacement de facteur a diminué de 4,633 à 1,505 unités. Dans l'évaluation radiographique, la progression de l'arthrite a été observée dans trois cas au dernier suivi. Une synovectomie arthroscopique du genou qui utilise des abords arthroscopiques appropriés est une méthode utile pour traiter les malades hémophiliques, diminuant les épisodes de saignement, la quantité de facteur et les douleurs du genou.

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“…The pre-operative median Petrini score was 13 (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)). The youngest patients had the best clinical status (q = 0.66, P \ 0.001).…”

Section: Resultsmentioning

confidence: 99%

“…Long-term results of synovectomy have never been reported. Before less invasive techniques such as arthroscopic, medical or isotopic synovectomies [10][11][12][13][14] have been proposed, open synovectomy was the reference procedure. The goal of this study is to report the long-term results of a monocentric series of open surgical synovectomy of the knee.…”

Section: Introductionmentioning

confidence: 99%

Surgical synovectomy of the knee in young haemophiliacs: Long-term results of a monocentric series of 23 patients

Rampal

Odent

Torchet

et al. 2010

Journal of Children's Orthopaedics

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Background In haemophiliacs, synovectomy is indicated for recurrent joint bleedings, despite medical treatment. Method We report a series of 23 surgical synovectomies of the knee with a median follow-up of 8.8 years. The median age of patients at surgery was 13.5 years. Clinical and radiological evaluations were made according to the Petrini and the Pettersson scores, at 1 and 5 years after surgery, and at the last follow-up. Wilcoxon and Spearman's tests were used for the statistical analysis. Result The Petrini score improved at 1 and 5 years (P \ 0.001). Nine patients have 20 years of follow-up and a stable result. In more than half of the knees, no episode of recurrent bleeding occurred. The effect of surgery on the range of motion (ROM) was moderate and mobilisation under anaesthesia did not improve it significantly. There was a progressive worsening of the radiological score, but no correlation between clinical and radiological score was noticed (q = 0.08, P = 0.77). Conclusion Complete synovectomy gives good long-term results in term of bleeding recurrence and overall function.

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Open and Arthroscopic Synovectomy in Hemophilic Arthropathy of the Knee

Cited by 46 publications

References 0 publications

Modern management of haemophilic arthropathy

Modern management of haemophilic arthropathy

Arthroscopic synovectomy in haemophilic arthropathy of the knee

Surgical synovectomy of the knee in young haemophiliacs: Long-term results of a monocentric series of 23 patients

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