Methods to treat chronic haemophilic synovitis

The aim of both synoviorthesis and surgical synovectomy is to remove the inflamed and hypervascular synovium as soon as possible in order to prevent the onset of haemophilic arthropathy. Ideally, however, these methods should be performed before the articular cartilage has eroded. Radioactive synoviorthesis is a relatively simple, virtually painless and inexpensive technique for the treatment of chronic haemophilic synovitis, even in patients with inhibitors. Thus, radioactive synoviorthesis is the best choice for patients with persistent synovitis. Personal experience and the general recommendation among orthopaedic surgeons and haematologists is that when three early consecutive synoviorthesis (repeated every 3 months) fail to halt synovitis, a surgical synovectomy (open or by arthroscopy) should be immediately considered.