Abstract
1385
Objectives We share our experience with 42 patients who underwent radiosynovectomy for indications of hemophilic arthropathy and PVNS. Radiosynovectomy involves intra-articular administration of radioisotopes to induce synovial ablation to prevent major articular surface erosion that leads to end-stage arthropathy, especially when systemic pharmacotherapy and intra-articular steroid injections have failed.
Methods A retrospective review of UNC clinical database was performed to search for patients who underwent radiosynovectomy from February 1998 to June 2009. 47 patients were identified, 1 patient deceased, 4 lacked follow-up. 42 remaining patients were selected for the study (42 males, 1 female). Mean age was 33 (range 16-80). 38 patients had hemophilic arthritis (A type 23, B type 15), while 4 patients had PVNS. Patients with history of 30 or more episodes of bleeding in 1 year were considered to be severely hemarthrotic. 1 mCi of chromic 32-Phosphorus was administered in large joints and 0.5 mCi in small joints. Significant decrease in frequency of hemarthrosis in the index joint 1 year after treatment was considered as positive response.
Results Favorable response in 24/42 (57%), and poor response in 18/42 (43%) was noted. Patients with hemophilia A: 13 favorable, 8 poor, and with Hemophilia B: 8 favorable, 7 poor. All 4 patients with PVNS and 5 pediatric patients showed favorable response (100%). However, 19/37 adult patients showed favorable response (51%). The mean age of both response groups is comparable. 11/42 patients belong to severely hemarthrotic group (26%). Of these, 9 patients demonstrated favorable response (82%).
Conclusions In our experience, radiosynovectomy produced clinically favorable response in more than half of patients. All patients with PVNS responded favorably, as did pediatric patients. Severely hemarthrotic patients responded more favorably to the treatment