Arthroscopic synovectomy considerably reduces bleeding frequency and improves joint function in hemophilic patients with chronic synovitis

SummaryBackground/IntroductionHemophilic arthropathy (HA) is the most common complication in patients with hemophilia. Arthroscopic synovectomy in HA is the optimal choice of treatment because it is less invasive.Purpose/AimTo demonstrate the effectiveness of arthroscopic synovectomy for HA involving the knees, elbows, and ankles.MethodsThis study retrospectively analyzed 11 patients with chronic synovitis with repeated hemoarthrosis (13 joints: 5 knees, 4 elbows, and 4 ankles) between August 2011 and August 2013. The joints that did not respond well to secondary prophylactic factor replacement and physical therapy underwent arthroscopic synovectomy for further treatment. Patient profiles, joint pain scores, bleeding frequency, and joint function scores were reviewed.ResultsThe mean visual analog scale scores for pain decreased from 77.1 mm preoperatively to 27.7 mm postoperatively (p < 0.05). The mean annual bleeding frequencies before and after surgery were 6.1 times/y and 2.0 times/y, respectively (p < 0.05). Functional scores for all the joints improved. The mean Lysholm knee scale score significantly increased from 45.2 preoperatively to 74.4 postoperatively (p < 0.05). No major complications were observed.ConclusionArthroscopic synovectomy, a less invasive procedure for HA, significantly reduced joint pain, prevented bleeding episodes, and improved joint function with few complications.