혈우병성 족관절염 환자에서관절경적 활액막 제거술의 단기 추시 결과

Abstract

Purpose: This study reports on the results of clinical and radiological evaluation of arthroscopic synovectomy in hemophilic ankle arthropathy. Materials and Methods: Between September 2006 and December 2008, arthroscopic synovectomy was performed on 35 ankle joints in 33 patients with hemophilic ankle arthropathy. The mean follow-up period was 30 months. The range of motion of joint and frequency of intra-articular bleeding and factor dose were evaluated for this study. American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hind foot score and subjective satisfaction were used for clinical assessment. Arnolf and Hilgartner classification was used for radiological assessment. Results: The mean dorsiflexion and plantar flexion were 10.1o, 30.1o, respectively, at preoperation and 11.3o, 28.2o, respectively on the final day of follow-up with no significant difference in the range of motion. The mean frequency of hemarthrosis decreased significantly to 0.6 times per month postoperative (p<0.05). The mean amount of factor replacement decreased from 5,320 units/mo preoperative to 4,568 units/mo postoperative with no significance difference. AOFAS ankle and hind foot score was improved to 90 points postoperative with significance. On radiologic evaluation, 33 cases showed no significant changes, while two cases had progressed at the last follow-up. Conclusion: Arthroscopic synovectomy for recurrent hemarthrosis in hemophilic ankle arthropathy is a useful method for familiar procedure, decreasing bleeding episodes and subjective satisfaction.