Sneppen O, Beck H, Holsteen V
Acta Paediatr Scand. 1978 Jul;67(4):491-5. doi: 10.1111/j.1651-2227.1978.tb16359.x.
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.
由于保守治疗无法控制频繁复发的关节积血，19例血友病患者共23个关节接受了滑膜切除术，其中17个膝关节、5个肘关节和1个髋关节。对患者平均随访23个月。8个关节出现了以再次出血为形式的术后原发性并发症。康复通常困难且持久，4例患者的关节活动范围基本受限。在随访超过6个月后，其余19个接受滑膜切除术且仍可活动的关节的情况如下：12个关节出血得到缓解，5个关节偶尔出血，2个关节频繁出血。出血次数的减少具有显著性（p小于0.01）。鉴于术后病程复杂，得出的结论是滑膜切除术应仅在严格的指征下使用，即仅用于进展性血友病性关节病的其他难以治疗的病例。
