Synovectomy as a prophylactic measure in recurrent haemophilic haemarthrosis. Follow-up of 23 cases.

Because of frequently recurring haemarthrosis which could not be controlled by conservative management 19 haemophiliacs were subjected to synovectomy on a total of 23 joints--17 knees, 5 elbows, and 1 hip. The patients were followed for an average of 23 months. Primary postoperative complications occurred, in the form of recurrent bleeding, in 8 joints. Rehabilitation was often difficult and long-lasting, and the range of joint motion was essentially restricted in 4 cases. After a follow-up period exceeding 6 months the findings in the remaining, mobile 19 synovectomized joints were: 12 had been relieved of haemorrhage, 5 had rare and two frequent haemorrhages. The reduction in the number of haemorrhages was significant (p is less than 0.01). In the light of the complicated postoperative course it is concluded that synovectomy should be used only on strict indications, viz. only in otherwise intractable cases of progressing haemophilic arthropathy.