P-32 chromic phosphate radio synovectomy for chronic haemophilic synovitis

The principal medical consequence of haemophilia is the development of arth ropathy, initiated by a haemarthrosis giving rise to chronic synovitis. Tra ditional methods of synovectomy include open excision and arthroscopy each of which require substantial amounts of clotting factor concentrate for sev eral weeks, and in the case of open synovectomy, is often associated with l oss of range of motion and arthrofibrosis. Radiosynovectomy, the intra-arti cular injection of low penetration radiocolloids, has been utilized outside the United States for over 20 years. Since 1988, our centre has performed 170 radio-synovectomies utilizing P-32 chromic phosphate (P-32). This study reports results of 130 P-32 radiosyovectomies with an average follow-up of 36.5 months (6-140 months). For primary procedures, excellent and good res ults (haemarthrosis reduction from 75 to 100%) were obtained in 79.2% of ca ses at 6 months to 8 years. For repeat procedures a combination of excellen t and good results were obtained in 62.4% of cases at 6 months to 3 years. Regression analysis showed no correlation between results and age or degree of arthropathy. Radiation was well contained within the joint. There were no observed or identified complications. The procedure is highly cost effec tive in comparison to open surgical or arthroscopic synovectomy.