Iranian Journal of Orthopedic Surgery

The Effect of P32 Radioactive Synoviorthesis in Hemophilic Synovitis: How Long Does It Last?

Document Type : Original Article

Authors

Amirreza Farhoud 1
Mohammadreza Razzaghof 2
Sepand Heidari 2
Ali Shbeeb 3
Gholamreza Toogeh 4
Mohammad Ayati Firoozabadi 2
Mohammad Eftekhari 5
Seyed Mohammad Javad Mortazavi 2

1 Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran- Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

2 1. Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran 2. Department of Orthopedic Surgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran

3 Joint Reconstruction Research Center, Tehran University of Medical Sciences, Tehran, Iran. Address: Department of Orthopedics, Imam Hospital Complex, Keshavarz Blvd., Tehran

4 Thrombosis Hemostasis Research Center, Tehran University of Medical Sciences, Tehran, Iran

5 Research Center for Nuclear Medicine, Tehran University of Medical Sciences, Tehran, Iran

https://doi.org/10.22034/ijos.2025.473513.1103
Abstract
Introduction: Radioactive synoviorthesis, used as a local treatment for hemophilic arthropathy, causes the ablation of sub-synovial vessels. Previous studies have indicated that this procedure is effective in reducing the frequency of hemarthrosis in patients with recurrent episodes. However, it remains unclear how long this effect lasts and whether it has any impact on radiologic changes.
Aim: To assess the impact of follow-up duration after synoviorthesis on the incidence of hemarthrosis, as well as the extent of clinical and radiological involvement of the joint.
Methods: Synoviorthesis using 32P was performed once on 56 target joints in 56 patients. Thirty cases (29 males and one female) with an average age of 15.7 years (SD: 6.1) and a follow-up duration of 21.8 months ( 3–36 months) were compared to 26 males with an average age of 17.8 years (SD: 8.4) and an average follow-up duration of 43.6 months (38–102 months).
Results: The average reduction in the rate of hemarthrosis was 56.4% in the ≤36-month follow-up group (p<0.05) and 35.9% in the >36-month follow-up group (p<0.05).
Although there was greater improvement in the ≤36-month group, the difference was not statistically significant. Additionally mean improvement in clinical grade (Fernandez-Palazzi) was 0.56 (SE: 0.21) in ≤36-month group (p<0.05) and 0.65 (SE: 0.28) in the >36-month group (p<0.05), with the slightly better results in the ≤36-month group also not being statistically significant. The mean increase in radiographic grade (Arnold-Hilgartner) was 0.25 (SE: 0.15) in the ≤36-month group and 0.78 (SE: 0.14) in the >36-month follow-up group, and this difference was statistically significant.
Conclusion: The beneficial effects of 32P synoviorthesis on clinical involvement in hemophilic arthropathy persist over time. Despite an initial reduction in its effectiveness, longer follow-up demonstrated that synoviorthesis remains durable procedure. However, this treatment modality was unable to halt the radiologic progression of joint degeneration

Keywords

Hemophilic arthropathy
Hemophilia
, P32 Synoviorthesis
, Radiologic involvement
, hemarthrosis

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