SURGICAL SYNOVECTOMY IN HEMOPHILIC ARTHROPATHY OF THE KNEE

Twenty seven patients with haemophilia who had repeated haemarthroses affecting the knee joint, despite appropriate substitution therapy, we re treated by surgical synovectomy. Open operations were carried out o n 18 and 9 had an arthroscopic procedure. The average age at the time of synovectomy was 13 years for both the open and arthroscopic groups. The open group was followed up for an average of 15.2 years and the c losed for 5.4 years. Operation took 70 minutes on average in the arthr oscopic group and 50 minutes in the open. Patients who had an arthrosc opy were in hospital for an average of 5 days and those with an open o peration for 10. Synovectomy by both methods significantly reduced ble eding episodes. The results were assessed according to the classificat ion recommended by the Orthopaedic Advisory Committee of the World Fed eration of Haemophilia. In the open group 2 patients had a good result , 10 were fair and 6 poor; in the arthroscopic group 3 had a good resu lt, 5 were fair and 1 poor Both operations appeared to slow, but did n ot halt, the radiographic deterioration of the joints.