Synoviorthesis versus synovectomy in the treatment of recurrent haemophilic haemarthrosis: long-term evaluation.

The authors report a long-term evaluation of the effects of chemical and surgical synovectomies performed in two groups of patients which were comparable as regards number of haemarthrosis per year and joint mobility. The results obtained indicated that both synovectomy and synoviorthesis were effective in reducing the bleeding episodes; however, while synovectomy stopped almost completely the recurrence of haemarthrosis, synoviorthesis in 3 patients younger than 12 years did not modify it and in one case it even increased the bleeding tendency. Moreover, the occurrence of arthritic pain was observed in 6 knees treated by synoviorthesis and only in 3 knees treated by synovectomy. Finally, the joint function was significantly reduced in the synoviorthesis group as compared to the synovectomy group. In conclusion, synovectomy gave better results than synoviorthesis but the latter treatment has a number of economical and technical advantages and should therefore be considered in patients older than 12 year of age with good joint function and without evident radiological changes, in whom full dose replacement therapy has had no effect on the recurrence of haemarthrosis.