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 (ρ = 0.08, P = 0.77). CONCLUSION: Complete synovectomy gives good long-term results in term of bleeding recurrence and overall function.
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 (ρ = 0.08, P = 0.77). CONCLUSION: Complete synovectomy gives good long-term results in term of bleeding recurrence and overall function.
Entities:
Keywords:
Haemophilia; Knee; Long-term results; Open synovectomy
Authors: Luigi P Solimeno; Maria E Mancuso; Gianluigi Pasta; Elena Santagostino; Samantha Perfetto; Pier Mannuccio Mannucci Journal: Br J Haematol Date: 2009-02-22 Impact factor: 6.998
Authors: Amy L Dunn; Michael T Busch; J Bradley Wyly; Kevin M Sullivan; Thomas C Abshire Journal: J Pediatr Orthop Date: 2004 Jul-Aug Impact factor: 2.324