Surgical synovectomy of the knee in young haemophiliacs: long-term results of a monocentric series of 23 patients

被引:6
作者
Rampal, Virginie [1 ]
Odent, T. [2 ]
Torchet, M. F. [3 ]
Rothschild, C. [3 ]
Elie, C. [4 ]
Glorion, C. [2 ]
Padovani, J. P. [2 ]
机构
[1] Univ Nice Sophia Antipolis, Serv Orthopedie Pediat, Hop Archet, 151 Rte St Antoine de Ginestiere, F-06202 Nice, France
[2] Univ Paris 05, Hop Necker, Serv Orthopedie Pediat, F-75015 Paris, France
[3] Univ Paris 05, Hop Necker, Ctr Hemophilie, F-75015 Paris, France
[4] Univ Paris 05, Hop Necker, Serv Sante Publ & Med Sociale, F-75015 Paris, France
关键词
Haemophilia; Knee; Open synovectomy; Long-term results;
D O I
10.1007/s11832-009-0229-y
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Background In haemophiliacs, synovectomy is indicated for recurrent joint bleedings, despite medical treatment. Method We report a series of 23 surgical synovectomies of the knee with a median follow-up of 8.8 years. The median age of patients at surgery was 13.5 years. Clinical and radiological evaluations were made according to the Petrini and the Pettersson scores, at 1 and 5 years after surgery, and at the last follow-up. Wilcoxon and Spearman's tests were used for the statistical analysis. Result The Petrini score improved at 1 and 5 years (P < 0.001). Nine patients have 20 years of follow-up and a stable result. In more than half of the knees, no episode of recurrent bleeding occurred. The effect of surgery on the range of motion (ROM) was moderate and mobilisation under anaesthesia did not improve it significantly. There was a progressive worsening of the radiological score, but no correlation between clinical and radiological score was noticed (q = 0.08, P = 0.77). Conclusion Complete synovectomy gives good long-term results in term of bleeding recurrence and overall function.
引用
收藏
页码:33 / 37
页数:5
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