Effect of radiosynoviorthesis on the progression of arthropathy and haemarthrosis reduction in haemophilic patients

• Published in: Haemophilia : the official journal of the World Federation of Hemophilia Vol. 23; no. 6; pp. e497 - e503
• Main Authors: Querol‐Giner, M., Pérez‐Alenda, S., Aguilar‐Rodríguez, M., Carrasco, J. J., Bonanad, S., Querol, F.
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.11.2017
• Subjects: Adolescent; Adult; Age; Ankle Joint - pathology; Ankle Joint - radiation effects; Ankle Joint - surgery; Bleeding; Disease Progression; Elbow Joint - pathology; Elbow Joint - radiation effects; Elbow Joint - surgery; haemarthrosis; haemophilic arthropathy; Hemarthrosis - etiology; Hemarthrosis - therapy; Hemophilia; Hemophilia A - complications; Humans; Joint Diseases - etiology; Joint Diseases - therapy; Middle Aged; Radiation; Radioisotopes - therapeutic use; radiosynoviorthesis; Retrospective Studies; Rhenium; Shoulder Joint - pathology; Shoulder Joint - radiation effects; Shoulder Joint - surgery; Synovectomy - methods; Synovial membrane; Synovitis; Synovitis - etiology; Synovitis - therapy; Treatment Outcome; Young Adult; Yttrium Radioisotopes - therapeutic use; haemarthrosis; radiosynoviorthesis; haemophilic arthropathy; synovitis
• ISSN: 1351-8216; 1365-2516; 1365-2516
• DOI: 10.1111/hae.13326

Introduction Repeated haemarthrosis is widely accepted as the triggering cause of synovitis and haemophilic arthropathy. A first‐line treatment of chronic synovitis is radiosynoviorthesis (RS). The aim of this study was to evaluate the RS effects on the progression of arthropathy and on a reduction in bleeding in patients with haemophilia. Methods An observational‐retrospective study was performed. Bleeding episodes in the 12 months following and in the 12 months preceding RS was compared. The arthropathy was clinically and radiologically analysed by age range, joint and subject, comparing those undergoing RS (Radiosynoviorthesis Group, RSG) against those not undergoing this treatment (Non‐Radiosynoviorthesis Group, Non‐RSG). Results One hundred and seventy‐four RS were performed in 71 patients (90Y in Knees and 186Re in elbows/ankles/shoulder). RS resulted in significant reduction in bleeding (582 preintervention and 168 postintervention, P < .001). In general, the level of arthropathy measured clinically and radiologically was greater with age increase in both groups (RSG and Non‐RSG), especially in the 25‐40 age range. A significant increase (P < .05) in the progression of arthropathy was also observed, both globally by patient and specifically for each joint, in non‐RSG and RSG group. Conclusion RS is an effective method to reduce the number of haemarthrosis episodes in chronic synovitis. Moreover, RS can positively affect arthropathy by slowing down its progression. However, the results obtained suggest that arthropathy may be conditioned by the subject's age, regardless of whether or not the joint has undergone RS.