Between 1977 and 1992, we performed ninety-two synoviortheses
(destruction of synovial tissue by intra-articular injection of a
radioactive agent) on forty-eight patients who had a severe congenital
disorder of hemostasis and chronic hemophilic synovitis that was resistant
to conventional treatment. Colloidal 32P chromic phosphate was injected
intra-articularly: 1.0 millicurie for knees and 0.5 millicurie for other
joints. The duration of follow-up ranged from one to fifteen years. The
frequency and importance of bleeding decreased in most of the patients. The
range of motion of half of the joints remained stable or improved and that
of the other half continued to decrease. Radiographic scores worsened
progressively despite the decreased frequency of hemarthrosis. In most
patients, the extra-articular leakage of the radioactive agent was slight.
Chromosome breakages were observed almost exclusively in patients who were
seropositive for human immunodeficiency virus and in whom the
CD4-lymphocyte count was decreased from normal. The patients' level of
satisfaction with the results was high.