Synoviorthesis in Young Patients with Hemophilia and Inhibitory Antibodies

Abstract

In five patients under the age of 15 with hemophilia and inhibitors, due to frequent joint bleedings, 13 joints were treated with synoviorthesis (intra-articular injection of radioactive gold). The patients received high doses of factor VIII/IX for 2-4 days or were treated simultaneously with tolerance induction according to the Malmö protocol. Of the 13 joints treated, a bleeding-free interval of more than 6 months was obtained in nine of which six remained free from bleedings for more than a year. Ease of performance, the limited requirements of pre- and postoperative care, and a definite decrease in the joint bleeding frequency render synoviorthesis well suited for use in hemophiliacs with inhibitors who are otherwise difficult to treat.