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Haemophilic synovitis of the elbow

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https://www.readbyqxmd.com/read/25240555/radiosynovectomy-in-haemophilia-long-term-results-of-500-procedures-performed-in-a-38-year-period
#1
E C Rodriguez-Merchan, H De la Corte-Rodriguez, V Jimenez-Yuste
BACKGROUND: Radiosynovectomy (RS) can reduce the number of haemarthroses in chronic haemophilic synovitis. The purpose of this study was to assess the effectiveness of RS in terms of the objective improvement of five parameters (number haemarthroses, articular pain, degree of clinical synovitis, clinical score of the World Federation of Haemophilia (WFH), and radiological score of the WFH. METHODS: In a 38-year period (1976-2013), five hundred radiosynovectomies were performed in 443 joints of 345 patients with haemophilia diagnosed with chronic synovitis...
November 2014: Thrombosis Research
https://www.readbyqxmd.com/read/24750967/-recurrent-intra-articular-bleeding-episodes-in-haemophiliacs-treatment-outcomes-in-the-patients-at-the-university-hospital-motol-in-1985-2005
#2
P Teyssler, T Trč, K Kološtová, V Bobek
PURPOSE OF THE STUDY: Chronic synovitis is a common finding in people with haemophilia. It regularly appears after recurrent episodes of intra-articular bleeding. The bleeding originates from the subsynovial venous plexus underlying the capsule where a lack of thromboplastic activity has been demonstrated. Therefore, the changed synovium appears to be a treatment target. There are several methods which can be used to remove the synovial layer from the joint. The aim of our study was to asses the efficacy of different treatment approaches used in a group of haemophiliacs between 1985 and 2005 in our hospital...
2013: Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca
https://www.readbyqxmd.com/read/23786892/haemophilic-synovitis-of-the-elbow-radiosynovectomy-open-synovectomy-or-arthroscopic-synovectomy
#3
REVIEW
E Carlos Rodriguez-Merchan
Arthroscopic synovectomy (AS) of the elbow, while providing similar pain relief to open synovectomy (OS), may place patients at higher risk for recurrence. The primary predictor of outcome is degree of pre-existing degenerative changes within the joint. Regarding haemophilia patients, radiosynovectomy (RS) is the best choice for patients with persistent synovitis of the elbow. In the elbow we recommend a dose of 30-40 megabecquerels (mBq) in children and a dose of 56-74 mBq in adults. If three consecutive RSs with 6 months intervals are ineffective, an AS or OS must be indicated...
July 2013: Thrombosis Research
https://www.readbyqxmd.com/read/23245712/consecutive-radiosynovectomy-procedures-at-6-monthly-intervals-behave-independently-in-haemophilic-synovitis
#4
Hortensia De La Corte-Rodriguez, E Carlos Rodriguez-Merchan, Victor Jimenez-Yuste
BACKGROUND: Previous studies on the same group of patients investigated here demonstrated the effectiveness of radiosynovectomy in the treatment of chronic haemophilic synovitis even if one, two or three radiosynovectomy procedures (RS-1, RS-2, RS-3) may be necessary. The purpose of this study was to determine whether the joints' response to each radiosynovectomy procedure behaved independently or not. MATERIALS AND METHODS: One hundred and fifty-six radiosynovectomies were performed in 104 joints of 78 people diagnosed with chronic haemophilic synovitis...
April 2013: Blood Transfusion, Trasfusione del Sangue
https://www.readbyqxmd.com/read/23171307/long-term-outcomes-in-haemophilic-synovitis-after-radiosynovectomy-using-rhenium-186-a-single-centre-experience
#5
B Zulfikar, C Turkmen, O Kilicoglu, F Dikici, F Bezgal, O Gorgun, O Taser
Radiosynovectomy has been performed successfully for more than 10 years in our hospital. This study investigated the long-term outcome in the context of time to progression (TTP) analysis and the factors influencing TTP following radiosynovectomy with Re-186 in patients with haemophilic synovitis. Radiosynovectomy performed in 165 joints (81 elbows, 74 ankles, 8 shoulder and 2 hip joints) of 106 patients (median age was 18.0 ± 7.5 years; 91 haemophilia A, 13 haemophilia B and 2 von Willebrand's disease between June 2001 and July 2011...
March 2013: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/22527294/an-uncommon-cause-of-elbow-synovitis-in-an-adult-haemophilia-patient
#6
E Carlos Rodriguez-Merchan, Victor Jimenez-Yuste
We present the case of an adult haemophilia patient that at clinical examination showed intense painless synovitis in his left elbow, with full range of movement, which was unresponsive to 1 month of on-demand haematologic treatment at home. Radiological examination demonstrated a spontaneous displaced fracture of the olecranon secondary to severe osteolysis, due to advanced haemophilic arthropathy. Then, the patient was treated with a posterior plaster splint to immobilize the joint for 3 weeks together with secondary prophylaxis (3000 IU twice a week for 3 months)...
July 2012: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
https://www.readbyqxmd.com/read/21951693/viscosupplementation-in-haemophilic-arthropathy-a-long-term-follow-up-study
#7
C Carulli, R Civinini, C Martini, S Linari, M Morfini, M Tani, M Innocenti
Haemophilic arthropathy is the most common clinical manifestation of haemophilia, secondary to recurrent haemarthroses and chronic synovitis. Modern bleeding-preventing drugs have limited significantly the incidence of severe arthropathy, and primary approach is usually conservative. Use of intra-articular injections of hyaluronan acid is considered one of the most efficient treatments for early stages of articular degenerative diseases. Assessment of long-term effectiveness of intra-articular administration of hyaluronic acid (HA) in knees, ankles and elbows of patients affected by haemophilic arthropathy was done for 46 patients (10 elbows, 24 knees and 25 ankles) affected by haemophilic arthropathy...
May 2012: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/21535325/what-patient-joint-and-isotope-characteristics-influence-the-response-to-radiosynovectomy-in-patients-with-haemophilia
#8
H de la Corte-Rodriguez, E C Rodriguez-Merchan, V Jimenez-Yuste
The literature describes radiosynovectomy (RS) as a good non-surgical option for reducing synovial membrane size and thus the number of haemarthrosis episodes. However, there are still many aspects concerning the beneficial effects of RS that have not been quantified. A total of 156 radiosynovectomies (RS) were performed in 104 joints corresponding to 78 haemophiliacs (yttrium-90, rhenium-186). The mean patient age was 18 years. In another study involving the same group of patients, the parameters that improved most after RS were pain and haemarthrosis, followed by the World Federation of Hemophilia clinical score, muscle strength and range of movement (ROM)...
September 2011: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/21306434/radiosynovectomy-in-patients-with-chronic-haemophilic-synovitis-when-is-more-than-one-injection-necessary
#9
Hortensia de la Corte-Rodriguez, Emerito-Carlos Rodriguez-Merchan, Victor Jimenez-Yuste
One hundred and fifty-six radiosynovectomies (RSs) were performed in 104 joints of 78 haemophilic patients diagnosed with chronic haemophilic synovitis. Mean patient age was 18 yr. Previous studies on the same group of patients indicated that RS is an effective procedure for treating chronic haemophilic synovitis, which may require the performance of 1-3 injections (RS-1, RS-2, RS-3), with a 6-month interval between them. Those studies also revealed that the parameters showing the greatest improvement after RS were pain and haemarthrosis, followed by the World Federation of Haemophilia (WFH) clinical score and muscle strength and range of motion...
May 2011: European Journal of Haematology
https://www.readbyqxmd.com/read/21070486/haemophilic-arthropathy-the-usefulness-of-intra-articular-oxytetracycline-synoviorthesis-in-the-treatment-of-chronic-synovitis-in-children
#10
R Bernal-Lagunas, J L Aguilera-Soriano, A Berges-Garcia, D Luna-Pizarro, E Perez-Hernandez
Synoviorthesis is already widely used in the treatment of chronic haemophilic synovitis. The aim of this study was evaluate the effectiveness of oxytetracicline synoviorthesis on the frequency of haemarthrosis in haemophilic children with chronic synovitis and its impact on joint function. Between January 2001 and October 2006, we performed 34 synoviorthesis in 28 paediatric patients (6-16 years old) with diagnosis of haemophilic arthropathy stage I-II. At each joint were administered five doses of oxytetracycline for five consecutive weeks at doses of 100 mg in elbow and ankle and 250 mg in the knee...
March 2011: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/21070482/ultrasound-detects-joint-damage-and-bleeding-in-haemophilic-arthropathy-a-proposal-of-a-score
#11
D Melchiorre, S Linari, M Innocenti, I Biscoglio, M Toigo, M M Cerinic, M Morfini
Haemarthrosis triggers haemophilic arthropathy (HA) because bleeding starts synovitis immediately, damages cartilage and leads to loss of function and disability. The aim of our study was to investigate the capacity of ultrasonography (US) in detecting bleeding and joint damage in HA. The joints of 62 patients (pts) with haemophilia A or haemophilia B were consecutively evaluated and scored (score ranging from 0 to 21) for effusion (E), bone remodelling (BR), cartilage damage (CD), synovial hypertrophy (SH), haemosiderin (H), osteophytes (O), haemarthrosis (Hae), erosion (Er) and fibrotic septa (FS) with US...
January 2011: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/20731723/radioactive-synovectomy-with-yttrium%C3%A2-%C3%A2-citrate-in-haemophilic-synovitis-brazilian-experience
#12
S Thomas, M B Gabriel, P E Assi, M Barboza, M L P Perri, M G P Land, E S Da Costa
Recurrent haemarthroses leading to chronic synovitis and arthropathy remain a major cause of morbidity in patients with haemophilia. Radioactive synovectomy (RS) is considered the first choice of treatment for chronic haemophilic synovitis. The aim of this study was to evaluate the effect of RS with Yttrium(90) citrate (C-Y(90)) in the joints of patients with chronic haemophilic synovitis. From 2003 to 2007, 245 joints (118 knees, 76 elbows, 49 ankles and two shoulders) of 190 patients with haemophilia or von Willebrand disease were submitted to RS with C-Y(90) at Hemocentro de Mato Grosso, Brazil...
January 2011: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/20518818/the-effectiveness-of-radioisotope-synovectomy-for-chronic-synovitis-in-turkish-paediatric-haemophiliacs-ankara-experience
#13
B Alioglu, H Ozsoy, G Koca, A Sakaogullari, B Selver, M Ozdemir, Y Dallar
  Between January 2006 and December 2009, 37 radioisotope synovectomy (RS) in 18 severe haemophilic patients (factor 8<1%) have been performed at our centre. The distribution of joint injected was as follows: rhenium-186 [Re186], 19 joints (ankles, 8 and elbows, 11) and yttrium-90 [Y90] 18 joints (knees, 18). Their mean age was 12 years (range: 8-20 years). Mean follow-up period after procedure was 22.6 months. We preferred to use Y90 for all large joints and Re186 for small joints. Haemophilic patients with grade-II or III synovitis were selected for RS in our study...
November 2010: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/19744251/assessment-of-the-progression-of-haemophilic-arthropathy-in-children
#14
H Pergantou, H Platokouki, G Matsinos, O Papakonstantinou, A Papadopoulos, P Xafaki, D Petratos, S Aronis
Arthropathy is considered as an irreversible and progressive complication in patients with haemophilia, even in children on prophylaxis. To estimate the progression of haemophilic arthropathy, 85 joints of 24 boys with severe (n = 18) and moderate (n = 6) haemophilia (A: 22, B: 2) were investigated with clinical examination, X-rays and magnetic resonance imaging (MRI) at two time periods (time 0 and 1). Patients' age at time 0 was 10.5 +/- 3.6 years and time elapsed to time 1 was 3.8 +/- 1.4 years. At time 0: all investigated joints had more than three bleeds...
January 2010: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/18976248/clinical-evaluation-after-1-year-of-153-samarium-hydroxyapatite-synovectomy-in-patients-with-haemophilic-arthropathy
#15
J U Calegaro, J Machado, J C DE Paula, J S C DE Almeida, L A Casulari
The aim is to evaluate the efficiency of the treatment with 153-samarium hydroxyapatite (153-Sm-HA) in haemophilic arthropathy. Thirty-one patients (30 males) with ages ranging from 8 to 34 years (average age = 20.6 years) were treated with fixed intra-articular dose of 185 MBq (5 mCi) and divided into two groups: infantile-juvenile (13 patients with up to 18 years of age, an average age of 12.7 years and arthropathy evolution of 7.8 years), and adult (18 patients older than 18 years, an average age of 24 years and arthropathy evolution of 18...
January 2009: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/18691374/successful-angiographic-embolization-of-recurrent-elbow-and-knee-joint-bleeds-in-seven-patients-with-severe-haemophilia
#16
R Klamroth, S Gottstein, E Essers, H Landgraf, M Wilaschek, J Oldenburg
In haemophilic joints with high-grade arthropathy, bleeds occur that do not respond to replacement therapy of the deficient coagulation factor. The reason may be pathologically reactive angiogenesis in chronic synovitis. Seven patients with severe haemophilia A or haemophilia B experienced recurrent massive bleeds of one elbow joint or knee joint in the absence of trauma. After initial application of factor VIII or IX (fVIII/fIX; 50 IU kg(-1) bodyweight), there was only slow and never complete relief of symptoms...
January 2009: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/18510538/orthopaedic-management-of-haemophilia-arthropathy-of-the-ankle
#17
G Pasta, A Forsyth, C R Merchan, S M J Mortazavi, M Silva, K Mulder, E Mancuso, O Perfetto, M Heim, H Caviglia, L Solimeno
Joint bleeding, or haemarthrosis, is the most common type of bleeding episode experienced by individuals with haemophilia A and B. This leads to changes within the joints, including synovial proliferation, which results in further bleeding and chronic synovitis. Blood in the joint can also directly damage the cartilage, and with repeated bleeding, there is progressive destruction of both cartilage and bone. The end result is known as haemophilic arthropathy. The joints most commonly affected are the knees, elbows and ankles, although any synovial joint may be involved...
July 2008: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/18371165/radioisotope-synovectomy-with-rhenium186-in-haemophilic-synovitis-for-elbows-ankles-and-shoulders
#18
K Kavakli, S Aydogdu, M Taner, Y Duman, C Balkan, D Y Karapinar, G Saydam, K Capaci, A Oktay
We have performed 221 radioisotope synovectomy (RS) in more than 150 children and young adults with haemophilia, age ranging 3-30 years (mean 15) in Ege Hemophilia Center, Izmir, Turkey for last 7 years. We always preferred to use Yttrium 90 (Y(90)) for knees; however, since 2005, we started using rhenium 186 (Re(186)) for medium-sized joints with respect to safety. In this article, we have evaluated long-term experience ranging from 6 months to 3 years (mean 18 months) with Re(186) for elbows (n = 35), ankles (n = 26) and shoulders (n = 2) in total of 63 RS procedures for 49 patients...
May 2008: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/18248407/the-co-effect-of-prophylaxis-and-radiosynovectomy-on-bleeding-episodes-in-haemophilic-synovitis
#19
J Brecelj, V Bole, M Benedik-Dolnicar, M Grmek
Prophylactic substitution treatment and radiosynoviorthosis have a leading role in preventing irreversible haemophilic arthropathy. The aim of the study was to evaluate the effects of prophylaxis treatment and radiosynovectomy on the length of intervals between subsequent haemorrhages in haemophilic patients. Thirty-three joints were treated with radiosynovectomy in 28 patients with bleeding disorders. (90)Y colloid was used in knees and (186)Re colloid for elbows, shoulders and ankles. Twenty patients were on prophylaxis...
May 2008: Haemophilia: the Official Journal of the World Federation of Hemophilia
https://www.readbyqxmd.com/read/17822521/prophylaxis-and-treatment-of-chronic-synovitis-in-haemophilia-patients-with-inhibitors
#20
E C Rodriguez-Merchan, L Valentino, M Quintana
Prophylaxis is paramount to try to avoid the development of haemophilic synovitis. The best treatment for synovitis in patients with inhibitors is radioactive synoviorthesis (rhenium for ankle and elbows, yttrium for knees). With both methods (prohylaxis and radioactive synoviorthesis), we can delay the development of severe haemophilic arthropathy, that eventually will require major orthopaedic surgery.
November 2007: Haemophilia: the Official Journal of the World Federation of Hemophilia
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