E. C. Rodriguez-Merchan Consultant Orthopaedic Surgeon, La Paz University Hospital, Madrid, Spain 3 3 2 18 1 A 25 40 U/kg 3 B2 1 Correspondence: E. C. Rodriguez-Merchan, Capitan Blanco Argibay 21-G-3A, 28029 Madrid, Spain. Fax: + 34 91 571 2871. Haemophilia (2001), 7, 1 5 Blackwell Science Ltd. MRI Nuss 2 21 MRI Nuss MRI 3 14
4 8 7, 9 90 90 Y 90 Y β 4 mm 2.7 100 200 nm 90 Y La Paz University Hospital 198 198 Au 90 Y 198 Au 155 mci 1510 mci VIII 198 Au 3 4 90 Y 90 Y 1 1 ml 5 mci 3 mci Löfqvist 10 9 19 198 Au 1 44 90 Y 45 12 9 3.5 70 11 1980 Carusso Carusso V. Pietrogrande personal communication 1987 1980 2 12, 13 90 Y 8 5 10 1 90 Y 3 1 3 5 15
Molho 90 Y 14 6 81 44 6 89 8 6 9 15 7 16 6 cm 9, 17 18 24 48 3 A A A 3 3 Menart 19 2 3 198 Au 75 90 Y 85 13, 19 3 3 3 90 Y 2 3 90 Y 7, 9, 15 HIV 16
CD4 200/mm 3 20 10 4 7, 21 90 Y 32 P 3 3 QOL 7 1 1 X 3 3 Table 1 0 Table 1. Results of the different kinds of methods to treat chronic haemophilic synovitis. Method [reference] Chemical synoviorthesis osmic acid [14] 45% rifampicin [12, 13] 85% Radioactive synoviorthesis Gold-198 [7, 10] 70% Yttrium-90 [11, 14] 85% Phosphorus-32 [21] 85% Synovectomy open [7, 16] 70% arthroscopic [7, 9, 17] 70% Percentage of good results 17
References 1 Nilsson IM, Berntorp E, LoÈ fqvist T, Pettersson H. Twenty- ve years experience of prophylactic treatment in severe hemophilia A and B. J Intern Med 1992; 232: 25±32. 2 Nuss R, Kilcoyne RF, Geraghty S et al. MRI ndings in haemophilic joints treated with radiosynoviorthesis with development of an MRI scale of joint damage. Haemophilia 2000; 6: 162±9. 3 Buzzard BM. Physiotherapy for prevention and treatment of chronic haemophilic synovitis. Clin Orthop 1997; 343: 42±6. 4 Erken EHW. Radiocolloids in the management of hemophilic arthropathy. Clin Orthop 1991; 264: 129±35. 5 Fernandez-Palazzi F, Rivas S, Cibeira JL, Dib O, Viso R. Radioactive synoviorthesis in hemophilic hemarthrosis. Clin Orthop 1996; 328: 14±18. 6 Rivard GE, Girard M, Belanger R, Jutras M, Guay JP, Marton D. Synoviorthesis with colloidal chromic phosphate for the treatment of hemophilic arthropathy. JBone Joint Surg (Am) 1994; 76A: 482±8. 7 Rodriguez-Merchan EC, Magallon M, Galindo E, 9 Lopez-Cabarcos C. Hemophilic synovitis of the knee and elbow. Clin Orthop 1997; 343: 47±53. 8 Rodriguez-Merchan EC, Caviglia HA, Magallon M, Perez-Bianco R. Chemical synovectomy vs radioactive synovectomy for the treatment of chronic haemophilic synovitis: a prospective short-term study. Haemophilia 1997; 3: 118±22. 9 Wiedel JD. Arthroscopic synovectomy of the knee in hemophilia. 10- to 15-year followup. Clin Orthop 1996; 328: 46±53. 10 LoÈ fqvist T, Petersson C, Nilsson IM. Radioactive synoviorthesis in patients with hemophilia with factor inhibitor. Clin Orthop 1997; 343: 37±41. 11 Villar A, Rodriguez-Merchan EC, Jimenez-Yuste V et al. Synovitis. Haemophilia 2000; 6: 400 (Abstr. 12). 12 Caviglia HA, Fernandez-Palazzi F, Maffei E, Galatro G, Barrionuevo A. Chemical synoviorthesis for hemophilic synovitis. Clin Orthop 1997; 343: 30±6. 13 Fernandez-Palazzi F, Rivas S, Viso R et al. Synovectomy with rifampicin in haemophilic haemarthroses. Haemophilia 2000; 6: 562±5. 14 Molho P, Verrier P, Stieltjes N et al. A retrospective study of chemical and radioactive synovectomy in severe haemophilia patients with recurrent haemarthrosis. Haemophilia 1999; 5: 115±23. 15 Greene WB. Synovectomy of the ankle for hemophilic arthropathy. J Bone Joint Surg (Am) 1994; 76A: 812±19. 16 Gilbert MS, Radomisli TE. Management of xed exion contracture of the elbow in haemophilia. Haemophilia 1999; 5 (Suppl. 1): 39±42. 17 Eickhoff HH, Koch W, Raderschadt G, Brackmann H-H. Arthroscopy for chronic hemophilic synovitis of the knee. Clin Orthop 1997; 343: 58±62. 18 Rodriguez-Merchan EC, Goddard NJ. Chronic haemophilic synovitis. In: Rodriguez-Merchan EC, Goddard NJ, Lee CA eds. Musculoskeletal Aspects of Haemophilia Oxford: Blackwell Science 2000: 43±9. 19 Menart C, Lalain JJ, Lienhart A, Dechavanne M, Negrier C. Case report. Safety and ef cacy of three arthroscopic procedures in two high-responder haemophiliacs. Haemophilia 1999; 5: 278±81. 20 Ragni MV, Crossett LS, Herndon JH. Postoperative infection following orthopaedic surgery in human immunode ciency virus-infected hemophiliacs with CD4 counts < or ˆ 200/mm 3. JArthroplasty 1995; 10: 716±21. 21 Mathew P, Talbut DC, Frogameni A et al. Isotopic synovectomy with P-32 in paediatric patients with haemophilia. Haemophilia 2000; 6: 547±55. 18