Arthroscopic synovectomy for chronic hemophilic synovitis of the knee.

Synovectomy for chronic hemophilic arthropathy is performed for the main purpose of stopping recurrent hemarthroses. The indications are frequent recurrent bleeds and persistent synovial hypertrophy. Five patients with chronic hemophilic arthropathy of the knee who underwent arthroscopic synovectomy between June 1980 and June 1981 represent the source for this discussion. Two of these patients subsequently developed a stress-induced joint bleed, one persisted in having an effusion but no recurrent bleeds, whereas the other patient developed recurrent bleeds and required a second synovectomy 4 years later. Another patient required a second arthroscopic procedure, with posteromedial synovial resection 10 months after the initial synovectomy not including the posteromedial compartment. He has not had a joint bleed since. The remaining two patients have had no recurrence of joint bleeding or synovial hypertrophy. All patients obtained their preoperative motion. No complications occurred as a result of these synovectomies. Subsequent synovectomies have produced one complication of a severe immediate postoperative hemarthrosis.