Radiosynoviorthesis in the treatment of posttraumatic joint bleedings of hemophilic patients (concerning hip, knee and ankle joints)-Hungarian experience.

INTRODUCTION: The surgical, arthroscopic synovectomy and radiosynovectomy (radiosynoviorthesis, RSO) all have great practical importance, since they can eliminate the posttraumatic joint bleedings and prevent the further joint destructions in hemophilic patients. The aim of this study was to examine the role of RSO in the prevention of joint bleedings in hemophilic patients. METHODS: 54 out of 684 RSO patients were hemophiliacs. Mean age of the patients was 32 years (range 14-51), therefore this is a relatively young patients' cohort. Radiosynovectomy was performed in 37 patients with hemophilia A and in 17 patients suffering from hemophilia B. Since hemophilia is a sex-linked (x-linked) recessive disorder, all of the patients were male. There was no acquired hemophiliac among the treated patients. RESULTS: The RSO resulted in a 95% decline in bleedings per year and eliminated the incidence of further bleedings in 55% of the treated joints. CONCLUSION: Our findings support the view that radiosynoviorthesis can be considered as the first choice treatment for posttraumatic joint bleedings of hemophilic patients.

Effectiveness evaluation of radiosynovectomy on the radiological progression of osteoarthritis of the knee joint.

OBJECTIVES: This study aims to analyze the effect of radiosynovectomy (RSO) on the radiological progression of osteoarthritis of the knee joint. PATIENTS AND METHODS: The study included 207 knee joints of 181 patients (72 males, 109 females; mean age 58 years; range, 19 to 65 years) that were performed RSO between 01 April 2003 and 31 December 2015 in the Department of Orthopedics and Traumatology at Uzsoki Hospital. A total of 111 right and 96 left knees were treated. The mean duration of follow-up was 8.7 years (range, 1 to 12 years). Of the 181 patients, both knee joints were treated in 26. RESULTS: Of the 207 treated knee joints, 163 had the same Kellgren-Lawrence grade at the time of follow-up compared to the grade at the time of RSO, while 44 had worse outcomes. This indicated that radiological progression was not present in 79% of the treated knee joints. The intraclass correlation coefficient (ICC) showed significantly strong agreement between the pre- and post-measurements (ICC=0.835, p<0.001). CONCLUSION: Radiosynovectomy was able to impede radiological progression in 79% of the treated joints and only one-grade deterioration was observed in 39 cases during follow-up.

Effect of a balance-training programme on postural balance, aerobic capacity and frequency of falls in women with osteoporosis: A randomized controlled trial.

OBJECTIVE: To investigate the effect of a 12-month complex balance-training programme on static and dynamic postural balance, aerobic capacity and frequency of falls in women with established osteoporosis. DESIGN: Randomized controlled trial in which the intervention group was assigned a 12-month exercise programme (3 times a week for 30 min) and the control group had no intervention. SUBJECTS: A total of 100 osteoporotic women with at least one previous fracture. METHODS: Performance-based Timed Up and Go (TUG), Berg Balance Scale (BBS) and stabilometric platform tests were used to evaluate balance. Aerobic capacity was measured by bicycle ergometry. Frequency of falls was assessed using a falls diary. RESULTS: After 1 year, there was a statistically significant difference between the improvement achieved in the intervention and control groups on the performance-based TUG, BBS and stabilometric platform tests (p < 0.05). Mean metabolic equivalent (MET) value decreased in the intervention group, from 4.91 to 3.82 (a significant difference from the change achieved in the control group; p = 0.05). Relative risk of falls was 0.534 at 1 year (p = 0.17). CONCLUSION: The 12-month balance-training programme significantly improved postural balance and increased aerobic capacity in women with established osteoporosis.

Effectiveness of balance training programme in reducing the frequency of falling in established osteoporotic women: a randomized controlled trial.

OBJECTIVE: To investigate the effect of a 12-month sensomotor balance exercise programme on postural control and the frequency of falling in women with established osteoporosis. DESIGN: Randomized controlled trial where the intervention group was assigned the 12-month Balance Training Programme and the control group did not undertake any intervention beyond regular osteoporosis treatment. SUBJECTS: A total of 100 osteoporotic women - at least with one osteoporotic fracture - aged 65 years old and above. MAIN MEASURES: Balance was assessed in static and dynamic posture both with performance-based measures of balance, such as the Berg Balance Scale and the Timed Up and Go Test, and with a stabilometric computerized platform. INTERVENTIONS: Patients in the intervention group completed the 12-month sensomotor Balance Training Programme in an outpatient setting, guided by physical therapists, three times a week, for 30 minutes. RESULTS: The Berg Balance Scale and the Timed Up and Go Test showed a statistically significant improvement of balance in the intervention group ( p = 0.001 and p = 0.005, respectively). Balance tests using the stabilometer also showed a statistically significant improvement in static and dynamic postural balance for osteoporotic women after the completion of the Balance Training Programme. As a consequence, the one-year exercise programme significantly decreased the number of falls in the exercise group compared with the control group. CONCLUSION: The Balance Training Programme significantly improved the balance parameters and reduced the number of falls in postmenopausal women who have already had at least one fracture in the past.