Sinoviortesis química con rifampicina en pacientes hemofílicos

Abstract

Aim

Synovitis is one of the most frequent complications of haemophilic disease produced by intra-articular deposits of hemosiderin.

Patients and methods

99 patients with haemophilia with 124 synovitis joints were treated with intra-articular rifampicin injection, between 1992 to 2001. The mean follow up was 5 years. Mean age was 15 years old. 12 patients had inhibitors to factor VIII. The joints affected were: 28 (22.6%) elbows, 19 (15.3%) ankles and 77 (62.1%) knees. The mean number or injections according each joint was: elbow: 4, ankle: 3 and knee: 7.

Results

101 (81,5%) joints showed excellent results, 17 (13.7%) good results and 6 (4.8%) poor results. Small joints (ankle and elbow) showed better results than big ones (knee) (p < 0,001). Patients with severe hemophilia had worse outcomes than patients with mild or moderate disease. Time of synovitis affected the outcome of the patients. Excellent results were seen in patients without recurrence.

Conclusion

Synoviorthesis with rifampicin seems to be an effective method for the treatment of synovitis, with excellent results specially in small joints with short period of evolution.