Clinical and Radiological Evaluation After Chemical Synovectomy With Rifampicin in Hemophilic Arthropathy: Korean Experience With a 2-Week Interval Protocol
Objective To assess the clinical outcome of chemical synovectomy with rifampicin in hemophilic arthropathy by using the World Federation of Hemophilia (WFH) scoring system and plain radiograph. Methods We performed rifampicin synovectomy (RS) on 30 joints of 28 hemophilic patients diagnosed as hemop...
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| Format: | Article |
| Language: | English |
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Korean Academy of Rehabilitation Medicine
2018-06-01
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| Series: | Annals of Rehabilitation Medicine |
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| Online Access: | http://www.e-arm.org/upload/pdf/arm-2018-42-3-449.pdf |
| _version_ | 1797727504010575872 |
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| author | Hoon Chang Suh Don-Kyu Kim Si Hyun Kang Kyung Mook Seo Hee Sang Kim Ji Young Lee Sang Yoon Lee Ki Young Yoo |
| author_facet | Hoon Chang Suh Don-Kyu Kim Si Hyun Kang Kyung Mook Seo Hee Sang Kim Ji Young Lee Sang Yoon Lee Ki Young Yoo |
| author_sort | Hoon Chang Suh |
| collection | DOAJ |
| description | Objective To assess the clinical outcome of chemical synovectomy with rifampicin in hemophilic arthropathy by using the World Federation of Hemophilia (WFH) scoring system and plain radiograph. Methods We performed rifampicin synovectomy (RS) on 30 joints of 28 hemophilic patients diagnosed as hemophilic arthropathy stage I–III (based on Fernandez-Palazzi clinical classification). Clinical status (bleeding frequency, pain, joint physical status) and radiological staging were evaluated as parts of the WFH scoring system before and 1 year after RS. The patients were divided into two groups by the Arnold-Hilgartner scale of the initial X-ray as stage 3 or less for the low-stage group (n=17) and over 3 for the high-stage group (n=13). Results Total WFH joint physical scores were reduced after injection, and the number of bleeding episodes and pain showed especially significant improvement. For other subscores of the WFH joint physical score, only swelling, range of motion, and crepitus showed statistically significant improvement. According to the severity of the radiologic finding, the WFH joint physical score of both the low-stage and high-stage groups showed significant improvement. In the radiological aspect, the low-stage group, without joint space narrowing at the initial plain radiograph, showed no further aggravation after injection. However, in the high-stage group, radiology found aggravation regardless of the procedure. Conclusion It is suggested that chemical synovectomy with rifampicin may prevent hemarthrosis and improve clinical symptoms. Especially in the early stage of arthropathy without joint-space narrowing, it seems to have an additional benefit that delays radiological aggravation and preserves joint status. |
| first_indexed | 2024-03-12T11:00:40Z |
| format | Article |
| id | doaj.art-8a6f37ab54ee4a98b5ce05218fe40a37 |
| institution | Directory Open Access Journal |
| issn | 2234-0645 2234-0653 |
| language | English |
| last_indexed | 2024-03-12T11:00:40Z |
| publishDate | 2018-06-01 |
| publisher | Korean Academy of Rehabilitation Medicine |
| record_format | Article |
| series | Annals of Rehabilitation Medicine |
| spelling | doaj.art-8a6f37ab54ee4a98b5ce05218fe40a372023-09-02T05:44:58ZengKorean Academy of Rehabilitation MedicineAnnals of Rehabilitation Medicine2234-06452234-06532018-06-0142344945610.5535/arm.2018.42.3.4494001Clinical and Radiological Evaluation After Chemical Synovectomy With Rifampicin in Hemophilic Arthropathy: Korean Experience With a 2-Week Interval ProtocolHoon Chang Suh0Don-Kyu Kim1Si Hyun Kang2Kyung Mook Seo3Hee Sang Kim4Ji Young Lee5Sang Yoon Lee6Ki Young Yoo7 Department of Physical Medicine and Rehabilitation, Chung-Ang University, College of Medicine, Seoul, Korea Department of Physical Medicine and Rehabilitation, Chung-Ang University, College of Medicine, Seoul, Korea Department of Physical Medicine and Rehabilitation, Chung-Ang University, College of Medicine, Seoul, Korea Department of Physical Medicine and Rehabilitation, Chung-Ang University, College of Medicine, Seoul, Korea Department of Physical Medicine and Rehabilitation, Chung-Ang University, College of Medicine, Seoul, Korea Department of Physical Medicine and Rehabilitation, Chung-Ang University, College of Medicine, Seoul, Korea Department of Rehabilitation Medicine, Seoul National University Boramae Medical Center, Seoul, Korea Korea Hemophilia Foundation, Seoul, KoreaObjective To assess the clinical outcome of chemical synovectomy with rifampicin in hemophilic arthropathy by using the World Federation of Hemophilia (WFH) scoring system and plain radiograph. Methods We performed rifampicin synovectomy (RS) on 30 joints of 28 hemophilic patients diagnosed as hemophilic arthropathy stage I–III (based on Fernandez-Palazzi clinical classification). Clinical status (bleeding frequency, pain, joint physical status) and radiological staging were evaluated as parts of the WFH scoring system before and 1 year after RS. The patients were divided into two groups by the Arnold-Hilgartner scale of the initial X-ray as stage 3 or less for the low-stage group (n=17) and over 3 for the high-stage group (n=13). Results Total WFH joint physical scores were reduced after injection, and the number of bleeding episodes and pain showed especially significant improvement. For other subscores of the WFH joint physical score, only swelling, range of motion, and crepitus showed statistically significant improvement. According to the severity of the radiologic finding, the WFH joint physical score of both the low-stage and high-stage groups showed significant improvement. In the radiological aspect, the low-stage group, without joint space narrowing at the initial plain radiograph, showed no further aggravation after injection. However, in the high-stage group, radiology found aggravation regardless of the procedure. Conclusion It is suggested that chemical synovectomy with rifampicin may prevent hemarthrosis and improve clinical symptoms. Especially in the early stage of arthropathy without joint-space narrowing, it seems to have an additional benefit that delays radiological aggravation and preserves joint status.http://www.e-arm.org/upload/pdf/arm-2018-42-3-449.pdfHemophiliaArthropathyRifampicinSynovectomy |
| spellingShingle | Hoon Chang Suh Don-Kyu Kim Si Hyun Kang Kyung Mook Seo Hee Sang Kim Ji Young Lee Sang Yoon Lee Ki Young Yoo Clinical and Radiological Evaluation After Chemical Synovectomy With Rifampicin in Hemophilic Arthropathy: Korean Experience With a 2-Week Interval Protocol Annals of Rehabilitation Medicine Hemophilia Arthropathy Rifampicin Synovectomy |
| title | Clinical and Radiological Evaluation After Chemical Synovectomy With Rifampicin in Hemophilic Arthropathy: Korean Experience With a 2-Week Interval Protocol |
| title_full | Clinical and Radiological Evaluation After Chemical Synovectomy With Rifampicin in Hemophilic Arthropathy: Korean Experience With a 2-Week Interval Protocol |
| title_fullStr | Clinical and Radiological Evaluation After Chemical Synovectomy With Rifampicin in Hemophilic Arthropathy: Korean Experience With a 2-Week Interval Protocol |
| title_full_unstemmed | Clinical and Radiological Evaluation After Chemical Synovectomy With Rifampicin in Hemophilic Arthropathy: Korean Experience With a 2-Week Interval Protocol |
| title_short | Clinical and Radiological Evaluation After Chemical Synovectomy With Rifampicin in Hemophilic Arthropathy: Korean Experience With a 2-Week Interval Protocol |
| title_sort | clinical and radiological evaluation after chemical synovectomy with rifampicin in hemophilic arthropathy korean experience with a 2 week interval protocol |
| topic | Hemophilia Arthropathy Rifampicin Synovectomy |
| url | http://www.e-arm.org/upload/pdf/arm-2018-42-3-449.pdf |
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