INTRAARTICULAR DEXAMETHASONE IN ADVANCED CHRONIC SYNOVITIS IN HEMOPHILIA

From 1988 to 1996, 34 patients with advanced chronic hemophilic synovi tis (25 Grade III and nine Grade IV) were treated with intraarticular injections of long acting dexamethasone (sodium phosphate of dexametha sone plus acetate of dexamethasone) in cycles of three injections with 3-week intervals between each injection with 6-month rest intervals b etween cycles for as many as three cycles, depending on the evolution of each case. All patients had chronic severe synovitis, axial deformi ty, muscular atrophy, and diminution of range of movement. There were 31 knees, two ankles, and two shoulders. Subjective and objective eval uations were done grouping the results in good, fair, and poor accordi ng to grade of patient satisfaction, presence of synovitis and pain, r ange of movement, and limitation of activities of daily living. In the subjective results there were 19 good results, 12 fair results, and f our poor results, and in the objective evaluation there were 22 good r esults, nine fair results, and four poor results at an average followu p of 1.5 years. The use of intraarticular dexamethasone as an alternat ive in the short to medium term for treatment of advanced chronic hemo philic synovitis with pain and limitation of function before doing an invasive surgical treatment is proposed.