J Mingo-Robinet1, T Odent2, C Elie3, M-F Torchet4, C Glorion2, J-P Padovani2, C Rothschild4. 1. Department of Orthopaedics and Traumatology, Complejo Asistencial Universitario de Palencia, Palencia, Spain. 2. Department of Pediatric Orthopedics, Hopital Universitaire Necker Enfants Malades, Assistance Publique Hopitaux de Paris, Paris, France. 3. Clinical Investigation Unit, Hopital Universitaire Necker Enfants Malades, Assistance Publique Hopitaux de Paris, Paris, France. 4. Haemophilia Care Centre, Hopital Universitaire Necker Enfants Malades, Assistance Publique Hopitaux de Paris, Paris, France.
Abstract
INTRODUCTION: In haemophiliacs, recurrent hemarthrosis and chronic synovitis lead to chronic arthropathy. Synovectomy is indicated when medical treatment fails. Few studies report the results of open synovectomy of the ankle in haemophiliacs with a small number of procedures and also a limited follow-up. AIM: The aim of this paper is to report the long-term results of open surgical synovectomy of the tibio-talar joint. METHODS: Thirty-two open synovectomies were performed in 21 young haemophiliacs in the same haemophilia center using an antero-lateral and postero-medial approaches. The median follow-up was 15.4 years. Clinical (Petrini scores) and radiological evaluations (Pettersson scores) were made preoperatively and at each multidisciplinary follow-up visit. Wilcoxon and Spearman's tests were used for the statistical analysis. RESULTS: Preoperative median Petrini score was 6 (range 3-12), and improved at 2 and 5 years follow-up (P = 0.0003 and P = 0.0001 respectively). At 10 and 15 years follow-ups, median score remained below preoperative score (median 3.5, range 0-11). Ten ankles had a follow-up of more than 20 years. Preoperative median Petterson score presented a slight but continuous worsening in the first 2 and 5 years of follow-ups (P = 0.02, P = 0.003), but not correlation between clinical and radiological results was observed. CONCLUSION: Our long-term results support that clinical scores are improved even if radiological scores progress. Open synovectomy retards the progression of the arthropathy, but not stops it. Bleeding and pain are controlled and even if recurrence of bleedings is frequent, it is less severe, less painful and requiring less factors replacement.
INTRODUCTION: In haemophiliacs, recurrent hemarthrosis and chronic synovitis lead to chronic arthropathy. Synovectomy is indicated when medical treatment fails. Few studies report the results of open synovectomy of the ankle in haemophiliacs with a small number of procedures and also a limited follow-up. AIM: The aim of this paper is to report the long-term results of open surgical synovectomy of the tibio-talar joint. METHODS: Thirty-two open synovectomies were performed in 21 young haemophiliacs in the same haemophilia center using an antero-lateral and postero-medial approaches. The median follow-up was 15.4 years. Clinical (Petrini scores) and radiological evaluations (Pettersson scores) were made preoperatively and at each multidisciplinary follow-up visit. Wilcoxon and Spearman's tests were used for the statistical analysis. RESULTS: Preoperative median Petrini score was 6 (range 3-12), and improved at 2 and 5 years follow-up (P = 0.0003 and P = 0.0001 respectively). At 10 and 15 years follow-ups, median score remained below preoperative score (median 3.5, range 0-11). Ten ankles had a follow-up of more than 20 years. Preoperative median Petterson score presented a slight but continuous worsening in the first 2 and 5 years of follow-ups (P = 0.02, P = 0.003), but not correlation between clinical and radiological results was observed. CONCLUSION: Our long-term results support that clinical scores are improved even if radiological scores progress. Open synovectomy retards the progression of the arthropathy, but not stops it. Bleeding and pain are controlled and even if recurrence of bleedings is frequent, it is less severe, less painful and requiring less factors replacement.
Authors: Nicolas de l'Escalopier; Alina Badina; Jean Paul Padovani; Annie Harroche; Laurent Frenzel; Philippe Wicart; Christophe Glorion; Chantal Rothschild Journal: Int Orthop Date: 2017-04-20 Impact factor: 3.075
Authors: Matteo Nicola Dario Di Minno; Mariasanta Napolitano; Anna Chiara Giuffrida; Erminia Baldacci; Christian Carulli; Elena Boccalandro; Clarissa Bruno; Eleonora Forneris; Irene Ricca; Walter Passeri; Marco Martinelli; Gianna Franca Rivolta; Luigi Piero Solimeno; Carlo Martinoli; Angiola Rocino; Gianluigi Pasta Journal: Br J Haematol Date: 2021-12-19 Impact factor: 8.615