Role of synovectomy in hemophilic arthropathy

Fifteen knee synovectomies performed in severe hemophiliacs between 1969 and 1971 were reevaluated after a follow-up period ranging from five to seven years. In the majority of cases (53%) there was no recurrence of hemarthrosis; in the others the condition was reduced (40%) or unchanged (7%) and joint scintiscans carried out with 99mTc showed a significant uptake of the tracer. Joint motion was markedly impaired in eight cases despite prolonged and intensive physiotherapy. The majority of patients expressed satisfaction with the operation, which had reduced the frequency and severity of joint bleeding and allowed them to lead more active lives. It is suggested that the possibilities of the conservative treatment presently available should be more extensively explored before establishing the indications for synovectomy.