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. 2005 Oct;29(5):296-300.
doi: 10.1007/s00264-005-0666-2. Epub 2005 Aug 5.

Arthroscopic synovectomy in haemophilic arthropathy of the knee

Kyoung Ho Yoon  1 , Dae Kyung Bae, Hee Sun Kim, Sang Jun Song
Affiliations

Arthroscopic synovectomy in haemophilic arthropathy of the knee

Kyoung Ho Yoon et al. Int Orthop. 2005 Oct.

Abstract
in English, French

From January 1996 to January 2001, arthroscopic synovectomies were performed in 28 knees with haemophilic arthropathy. The mean follow-up period was 5 years and 11 months. Six portals (two anterior, two suprapatellar, two posterior) and a posterior trans-septal portal were used in all cases. The average Hospital for Special Surgery (HSS) knee score increased from 56.4 to 71.5 points at the last follow-up. The average frequency of haemarthrosis reduced from five times per month before operation to once per month. The amount of factor replacement decreased from a mean of 4,633 U to 1,505 U. Progression of arthritis was observed radiographically in three cases at the last follow-up. An arthroscopic synovectomy of the knee using appropriate arthroscopic portals is a useful method in treating haemophilic patients as it decreases bleeding episodes, amount of factor replacement and knee pain.

De janvier 1996 à janvier 2001, des synovectomies arthroscopiques ont été exécutées dans 28 genoux avec une arthropathie hémophilique. Le suivi moyen était 5 années et 11 mois. Six abords (deux antérieurs, deux supra-rotuliens, deux postérieurs) et un abord trans-septal postérieur ont été utilisé dans tous les cas. Le score moyen du genou de l’Hôpital pour Chirurgie Spéciale (HSS) a augmenté de 56,4 à 71,5 points au dernier examen. La fréquence moyenne d’hémarthrose s’est réduite de cinq fois par mois avant l’opération à une fois par mois aprés. La quantité moyenne de remplacement de facteur a diminué de 4,633 à 1,505 unités. Dans l’évaluation radiographique, la progression de l’arthrite a été observée dans trois cas au dernier suivi. Une synovectomie arthroscopique du genou qui utilise des abords arthroscopiques appropriés est une méthode utile pour traiter les malades hémophiliques, diminuant les épisodes de saignement, la quantité de facteur et les douleurs du genou.

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Figures

Fig. 1
Fig. 1
Pre-operative arthroscopic pictures: a posteromedial compartment through the anterolateral portal, b posterolateral compartment through the anteromedial portal, c suprapatellar pouch through the anterolateral portal
Fig. 2
Fig. 2
Post-operative arthroscopic pictures: a posterior transseptal portal through the posterolateral portal, b posterior trans-septal portal through the posteromedial portal, c suprapatellar pouch through the anterolateral portal
Fig. 3
Fig. 3
a Pre-operative radiograph of a 26-year-old patient with severe haemophilia A showing stage III radiographic findings. b Radiograph taken at 5 years and 5 months after a synovectomy, indicating no change and no progression
See this image and copyright information in PMC

References

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