Yttrium-90 synovectomy in hemophilic arthropathy: An institutional experience for 15 years

Objective: The objective of this study is to assess the efficacy of Yttrium-90 (Y-90) radiation synovectomy in decreasing the recurrent bleeding episodes in hemophilic joints. Subjects and Methods: A retrospective analysis of patients who had Y-90 synovectomy from January 2001 to January 2016 was done. Among them, patients with minimum follow-up of 6 months were selected. The response in terms of decrease in the number of bleeding episodes was evaluated. Results: A total of 167 patients (243 joints) with hemophilia had radiation synovectomy over 15 years. Those with a minimum follow-up of 6 months were 155 joints (115 patients). The age ranged from 5 to 43 years and included 113 male and two female patients. Data for 11 joints were unavailable as these patients were lost to follow-up. The assessment of response for the remaining 144 joints was done based on the data available for different follow-up periods. They were divided into the following - 7 months to 2 years (89 joints), 3-5 years (6 joints), 6-10 years (39 joints), and above 11 years (10 joints). Overall, 37.4% of the joints had complete response, 56% had partial response, and 6% of the joints had no response. Conclusion: Radiation synovectomy is a noninvasive and effective modality which decreases the bleeding episodes in hemophiliac joints and improves the quality of life remarkably.