The role of synovectomy in the management of recurrent haemarthroses in XXXX .

@entity1 @entity548 @entity447 @entity797 @entity14228 @entity2720
Between August 1973 and May 1979, 18 @entity1 suffering from severe @entity447 A underwent synovectomy for recurrent haemarthroses, resistant to medical management. A total of 23 joints (11 knees and 12 elbows) were subjected to operation, five @entity1 undergoing two synovectomies on different joints. Post-operative follow-up period ranged from 12 to 58 months for @entity14228 and from 29 to 76 months for knee synovectomy. All @entity1 experienced fewer haemarthroses, the average number of @entity548 episodes per joint over a 12 month period being reduced from 19 to 3 for knee joints, and from 24 to 3 for @entity2720 . This improvement was apparent in the immediate post-operative year and maintained thereafter. Over the same follow-up period nine of the 11 knee joints were found to have lost an average 42 degrees mobility. Following @entity14228 five out of 12 @entity1 lost an average of 28 degrees mobility; six @entity1 gained an average 11 degrees mobility. The post-operative complication rate was high for knee synovectomy, 54% suffering @entity548 despite haemostatic factor @entity797 levels. For @entity14228 the rate was much lower, 75% of operations being uncomplicated. The average in- @entity1 time for knee operation was 75 d, and for the elbow 19 d. We conclude that synovectomy of the knee joint is to be avoided when other means of reducing @entity548 episodes are available, whereas @entity14228 retains a useful role in the treatment of recurrent haemarthroses which do not respond to clotting factor prophylaxis.
