Introduction: Radiosynovectomy (RS) with Y-hydroxyapatite (Y-HyA) aims to control knee hemarthrosis in hemophiliac patients to prevent secondary arthropathy. However, knee RS using Sm-hydroxyapatite (Sm-HyA) is considered less suitable due to the lower average soft tissue range and energy of Sm for large joints, such as the knees.
Purpose: The objective of this investigation was to assess the efficacy and safety of knee RS with Sm-HyA, compared to Y-HyA.
Methods: Forty patients were prospectively assigned to undergo knee RS with Sm-HyA (n = 19) or with Y-HyA (n = 21). The frequency of hemarthrosis episodes before and after treatment were compared.
Results: After six months of knee RS, Sm-HyA and Y-HyA promoted a similar reduction of hemarthrosis episodes (50% and 66.7%, respectively). However, after 12 months of knee RS, the reduction of hemarthrosis episodes was significantly (p = 0.037) higher using Sm-HyA (87.5%) compared to Y-HyA (50.0%). This discrepancy was more pronounced (p = 0.002) for Sm-HyA compared to Y-HyA in adults/adolescents.
Conclusion: Knee radiosynovectomy with Sm-HyA is safe, reduces hemarthrosis episodes after 12 months of treatments, especially in adults/adolescents and even with grades III/IV arthropathy, similar to Y-HyA. Y-HyA seems to promote better hemarthrosis control in small children.
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