Yttrium-90 synoviorthesis for chronic haemophilic synovitis: Madrid experience

Between 1994 and 1999 we performed 66 Yttrium-90 (Y-90) synoviortheses on 4 4 persons with haemophilia (45 knees, 12 elbows, nine ankles). At the time of injection 23 patients were HIV+ and two had inhibitors. The average age was 21.1 years (range: 9-39). Five mCi of Y-90 were injected into the knees , and 3 mCi into the elbows and ankles. The average follow-up was 3.5 years (range: 1-6). Of the 45 knees, there were eight excellent, 10 good, 15 fai r and 12 poor results. Of the 12 elbows there were three excellent results, five good, three fair and two poor. Of the nine ankles there were no excel lent results, four good, three fair and two poor. The elbows had better res ults than the knees and ankles. The best results were obtained in the young est patients, and in those with a moderate degree of synovitis, regardless of their HIV status and the presence of inhibitor. Y-90 synoviorthesis shou ld be performed in very young patients, when the amount of synovium is stil l moderate. Once the degree of synovitis has become severe, the expected re sults of radioactive synoviorthesis are worse.