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Pathogenesis and treatment options for hemophilic synovitis

Carlos Rodriguez-Merchan, E; Liddle, AD; (2017) Pathogenesis and treatment options for hemophilic synovitis. Expert Opinion on Orphan Drugs , 5 (2) pp. 173-179. 10.1080/21678707.2017.1279050. Green open access

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Abstract

INTRODUCTION: Hemophilia is characterized by recurrent bleeding episodes, most commonly in the knees, elbows and ankles. Repeated hemarthroses lead to synovial hypertrophy and a vicious cycle of chronic synovitis arises, leading to destruction of the joint. AREAS COVERED: This article covers the pathogenesis of chronic hemophilic synovitis and its treatment by means of different types of synovectomy. EXPERT OPINION: Both radiosynovectomy (RS) and arthroscopic synovectomy considerably improve the frequency of bleeding episodes. RS is the best option for patients with synovitis unresponsive to a three-month trial of hematological prophylaxis. If the bleeding is refractory to three successive episodes of RS at six monthly intervals, arthroscopic synovectomy is indicated. Open synovectomy should be reserved for adults with elbow synovitis requiring radial head removal and synovectomy in the same surgical session. RS is effective and safe, and particularly helpful in patients with inhibitors as they are at greatest risk of bleeding episodes and have the highest risk of complications of surgery.

Type: Article
Title: Pathogenesis and treatment options for hemophilic synovitis
Open access status: An open access version is available from UCL Discovery
DOI: 10.1080/21678707.2017.1279050
Publisher version: https://doi.org/10.1080/21678707.2017.1279050
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Science & Technology, Life Sciences & Biomedicine, Pharmacology & Pharmacy, Hemophilia, synovitis, pathogenesis, treatment, radiosynovectomy, arthroscopic synovectomy, Induced Joint Damage, P-32 Chromic Phosphate, Arthroscopic Synovectomy, Radionuclide Synovectomy, Short-Term, Follow-Up, Radiosynovectomy, Arthropathy, Synoviorthesis, Radiosynoviorthesis
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Eastman Dental Institute
URI: https://discovery.ucl.ac.uk/id/eprint/10046657
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