Arthroscopic synovectomy in haemophilic arthropathy of the knee

Abstract

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 supra-rotuliens, deux postérieurs) et un abord trans-septal postérieur 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 fréquence 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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Correspondence to Kyoung Ho Yoon.

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Yoon, K.H., Bae, D.K., Kim, H.S. et al. Arthroscopic synovectomy in haemophilic arthropathy of the knee. International Orthopaedics (SICOT) 29, 296–300 (2005). https://doi.org/10.1007/s00264-005-0666-2

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Keywords

  • Factor Replacement
  • Arthroscopic Synovectomy
  • Radiation Synovectomy
  • Posteromedial Portal
  • Open Synovectomy