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

摘要

Abstract Aim We previously reported the outcome of chromic phosphate‐32( 32 P) 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.