90 Yttrium-hydroxyapatite: a new therapeutic option for radioactive synovectomy in haemophilic synovitis

Recurrent haemarthroses often lead to chronic synovitis in patients with haemophilia and von Willebrand disease. Radioactive synovectomy with yttrium-90 ( 90 Y) citrate is frequently used to treat this complication, usually with good results. Since 2006, the Nuclear Energy Research Institute (IPEN, Sao Paulo, Brazil) has produced hydroxyapatite particles labelled with 90 Y for radioactive synovectomy. The aim of this study was to compare the results achieved by both forms of 90 Y in the treatment of haemophilic synovitis. We included 221 joints from 136 patients (age range: 6–20 years), treated by one of the two radiopharmaceu-ticals, at the Hemocenter of Mato Grosso, Brazil. The outcomes analysed were the annual frequency of haem-arthrosis, articular pain and joint range of motion before and 1 year after RS. Similar results were achieved regardless of whether 90 Y hydroxyapatite or 90 Y citrate was used, and results were independent of the joint type, age, gender, radiologic stage and presence of inhibitors. 90 Y hydroxyapatite appears to be equivalent to the reference product 90 Y citrate in the treatment of chronic synovitis associated with bleeding disorders.