SYNOVIORTHESIS WITH COLLOIDAL P-32 CHROMIC PHOSPHATE FOR THE TREATMENT OF HEMOPHILIC ARTHROPATHY

Between 1977 and 1992, we performed ninety-two synoviortheses (destruc tion of synovial tissue by intra-articular injection of a radioactive agent) on forty-eight patients who had a severe congenital disorder of hemostasis and chronic hemophilic synovitis that was resistant to con ventional treatment. Colloidal P-32 chromic phosphate was injected int ra-articularly: 1.0 millicurie for knees and 0.5 millicurie for other joints. The duration of follow-up ranged from one to fifteen years. Th e frequency and importance of bleeding decreased in most of the patien ts. The range of motion of half of the joints remained stable or impro ved and that of the other half continued to decrease. Radiographic sco res worsened progressively despite the decreased frequency of hemarthr osis. In most patients, the extra-articular leakage of the radioactive agent was slight. Chromosome breakages were observed almost exclusive ly in patients who were seropositive for human immunodeficiency virus and in whom the CD4-lymphocyte count was decreased from normal. The pa tients' level of satisfaction with the results was high.