Synovectomy by 153samarium-hydroxyapatite in ankles and elbows in patients with hemophilic arthropathy

Abstract

Objective: To evaluate the effects of synoviorthesis with 153samarium-hydroxyapatite (153Sm-HA) on elbows and ankles in patients with hemophilic arthropathy. Methods: Synovectomy was performed with 153Sm-HA (doses of 185 MBq) in 166 joints of 82 hemophilic patients with a mean age of 24.48 years (5 to 56) and mean follow-up of 39.82 months (6 to 76). The number of episodes of hemarthrosis, the use of clotting factor before and after the procedure, the scale of pain and the degree of patient satisfaction after treatment were evaluated. Results: Infiltration of only one 153Sm-HA dose was effective in 76.5% of patients to resolve the recurrent bleeding and/or synovitis in elbows and ankles. Others 16.8% had improvement after two procedures, 6.7% required three or four doses or had a bad response with the method. A significant reduction of 72% (pConclusion: The use of 153Sm-HA in the treatment of hemophilic arthropathy in elbows and ankles was safe, minimally invasive and effective in controlling bleeding and pain.