Shahid Beheshti University of Medical Sciences, Taleghani Hospital, Tehran, Iran.
Joint Reconstruction Research Centre, Tehran University of Medical Sciences, Tehran, Iran.
Haemophilia. 2020 Jan;26(1):136-141. doi: 10.1111/hae.13879. Epub 2019 Dec 3.
We previously reported the outcome of chromic phosphate-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.
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).
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).
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.
我们之前报道了 53 例血友病患者接受磷酸铬-32（P）胶体滑膜切除术的结果，平均随访 31 个月。本研究的目的是对同一队列进行长期随访，评估其临床和影像学特征。
9 例患者未能按时复诊。其余 44 例（52 个关节）患者的平均随访时间为 15 年（范围，14.6-15.5 年）。再次评估时的平均年龄为 31 岁（范围，18-43 岁）。
与 31 个月时相比，最新随访时的关节积血频率无统计学意义（0.8 次/周比 0.4 次/周，P=.3）。血友病性关节炎的临床严重程度无显著变化（P=.5）。大多数治疗关节仍处于 Fernandez-Palazzi 和 Caviglia 分类的第 III 期。关节炎的影像学恶化呈进展趋势，近 50%的患者达到 Arnold-Hilgartner 第 V 期。13%的患者接受了全膝关节置换术（TKA）。接受初次放射性滑膜切除术的年龄在接受 TKA 的患者中明显高于未接受 TKA 的患者（22 岁比 15 岁，P<.002）。
32P 对靶关节的止血效果随时间推移而保持，但似乎并未阻止血友病患者影像学改变的进展。如果及时进行治疗，它可以延迟 TKA 的需求。
