Radionuclide synovectomy/synoviorthesis (<scp>RS</scp>) in patients with bleeding disorders: A review of patient and procedure demographics and functional outcomes in the <scp>ATHN</scp>dataset

McGuinn, Catherine E.; Cheng, Dunlei; Aschman, Diane; Carpenter, Shannon L.; Sidonio, Robert F.; Soni, Amit; Tarantino, Michael D.; Wheeler, Allison P.; Dunn, Amy L.

doi:10.1111/hae.13318

Cited by 8 publications

(9 citation statements)

References 28 publications

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“…Since 1970s, multiple studies have demonstrated the effectiveness of radioactive synovectomy utilizing various agents such as gold‐198 (198Au), yttrium‐90 (90Y), rhenium‐186 (186Re) and chromic phosphate‐32 (32P) …”

Section: Introductionmentioning

confidence: 99%

Chromic phosphate‐32 colloid radiosynovectomy for the treatment of haemophilic synovitis: A long‐term follow‐up study

et al. 2019

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Aim We previously reported the outcome of chromic phosphate‐32(32P) colloid synoviorthesis in 53 haemophilic patients with an average follow‐up of 31 months. The purpose of the present study was the long‐term follow‐up of the same cohort on both clinical and radiographic features. Materials Nine patients failed to attend the recall appointment. The mean follow‐up for the remaining 44 patients (52 procedures) was 15 years (range, 14.6‐15.5). The mean age at the time of reassessment was 31 years (range, 18‐43). Results The haemarthrosis frequency was not statistically significant at the latest follow‐up years compared with 31 months (0.8 vs 0.4 per week, P = .3). There was no significant change in the clinical severity of haemophilic arthropathy (P = .5). Most of the treated joints still are in stage III of Fernandez‐Palazzi and Caviglia classification. There was a trend towards the radiologic deterioration of arthritis with nearly 50% of patients at Arnold‐Hilgartner Stage V. 13% of patients underwent a total knee arthroplasty (TKA). The age at which the initial radiosynovectomy was performed was significantly higher in patients who had a TKA than those who had not (22 vs 15 years, P < .002). Conclusion The bleeding control effect of 32P on the target joint remains over time; however, it did not appear to halt the progression of radiographic changes in haemophiliacs. It could delay the need for TKA if it performs at the right time.

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Section: Introductionmentioning

confidence: 99%

Chromic phosphate‐32 colloid radiosynovectomy for the treatment of haemophilic synovitis: A long‐term follow‐up study

et al. 2019

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“…Radioisotope synovectomy using a pure beta emitter (phosphorus‐32, yttrium‐90, and rhenium) is highly effective, has few side effects, and can be accomplished in a single outpatient procedure. 78 , 79 , 80 , 81 , 82 …”

Section: Resultsmentioning

confidence: 99%

“…[75][76][77] Radioisotope synovectomy using a pure beta emitter (phosphorus-32, yttrium-90, and rhenium) is highly effective, has few side effects, and can be accomplished in a single outpatient procedure. [78][79][80][81][82] However, limitations due to radionuclide availability and fear of potential related risk (seldom reported) should be considered. In addition, although synovectomy/synoviorthesis is known to reduce synovitis and, in turn, the frequency of bleeding episodes, no evidence about specific effects on articular degeneration are known.…”

Section: Role Of Orthopaedic Surgery (Table Iv)mentioning

confidence: 99%

Diagnosis and treatment of chronic synovitis in patients with haemophilia: consensus statements from the Italian Association of Haemophilia Centres

et al. 2021

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Although synovitis is recognized as a marker of joint disease activity, its periodic assessment is not included in routine clinical surveillance of patients with haemophilia (PwH). In order to evaluate the current knowledge and to identify controversial issues, a preliminary literature search by the Musculoskeletal Committee of the Italian Association of Haemophilia Centres (AICE) has been conducted. Statements have been established and sent to the Italian AICE members to collect their level of agreement or disagreement by a Delphi process. Thirty-seven consensus recommendations have been drafted. We found a general agreement on the indication to consider the presence of synovitis as a marker of joint disease activity in PwH. Accordingly, there was agreement on the indication to search for synovitis both in patients reporting joint pain and in asymptomatic ones, recognizing ultrasound as the most practical imaging technique to perform periodic joint screening. Interestingly, after detection of synovitis, there was agreement on the indication to modify the therapeutic approach, suggesting prophylaxis in patients treated on demand and tailoring treatment in patients already under prophylaxis. Whereas the need of an early consultation with a physiotherapist is recommended for PwH affected by chronic synovitis, the exact timing for an orthopaedic surgeon consultation is currently unknown.

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“…Several approaches for synovial ablation are described. Radioactive or chemical synovial ablation is effective and require minimal CFC prophylaxis compared to classical open or arthroscopic synovectomy . Another procedure is angiographic embolization of synovial arteries which also needs minimal CFC prophylaxis .…”

Section: Haemostatic Surgical Proceduresmentioning

confidence: 99%

Low‐dose surgical prophylaxis: Optimization of use of World Federation of Hemophilia Humanitarian Aid donated clotting factor concentrates to developing countries

Ekiaby¹,

Haffar

2020

Haemophilia

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Background Patients with hemophilia (PWH) might need surgical interventions during the course of their lives. Such medical interventions pose hemostatic challenges and requests infusion of clotting factor concentrates (CFCs) during peri and postoperative for variable periods to prevent bleeding and until complete wound healing. Access to CFCs to PWH living in resource limited settings is usually a challenge which makes surgical interventions either risky or not practical. Recently World Federation of Hemophilia (WFH) started a humanitarian aid program to channel CFCs into resource limited countries and which allowed the possibility to perform surgical interventions for PWH in these countries. Aim of work To study safety and efficacy of using lower doses of CFCs for surgical prophylaxis. Methods Review of literature and our center experience to demonstrate safety and efficacy of low dose surgical prophylaxis using CFCs Results Several elements can help using lower doses of CFCs for surgical prophylaxis in resource limited setting. These elements include severity of hemophilia, type of surgical procedure, the use of hemostatic surgical techniques, the type of CFCs, the mode of infusion of CFCs and finally the use of adjunctive therapies Conclusion Management of surgical procedures for PWH in a multidisciplinary specialized hemophilia treatment centers with proper understanding of hemostatic and surgical challenges of the procedure can allow for safe and effective use of lower doses of CFCs for surgical prophylaxis.

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Radionuclide synovectomy/synoviorthesis (RS) in patients with bleeding disorders: A review of patient and procedure demographics and functional outcomes in the ATHNdataset

Cited by 8 publications

References 28 publications

Chromic phosphate‐32 colloid radiosynovectomy for the treatment of haemophilic synovitis: A long‐term follow‐up study

Chromic phosphate‐32 colloid radiosynovectomy for the treatment of haemophilic synovitis: A long‐term follow‐up study

Diagnosis and treatment of chronic synovitis in patients with haemophilia: consensus statements from the Italian Association of Haemophilia Centres

Low‐dose surgical prophylaxis: Optimization of use of World Federation of Hemophilia Humanitarian Aid donated clotting factor concentrates to developing countries

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