A 35-year-old man with hemophilia A presents with recurrent hemarthrosis of the right knee causing chronic synovial hypertrophy and progressive joint destruction refractory to factor VIII prophylaxis. The preferred surgical intervention to arrest disease progression and prevent further bleeds is:
- A Radioactive synovectomy (Yttrium-90) ✓
- B Total knee arthroplasty
- C Arthroscopic synovectomy
- D Above-knee amputation
Correct answer: A. Radioactive synovectomy (Yttrium-90)
Explanation
Radiation synovectomy using Yttrium-90 (or P-32) is the procedure of choice for chronic hemophilic synovitis refractory to factor replacement. It reduces bleed frequency by inducing synovial fibrosis. Total knee arthroplathy is reserved for end-stage joint destruction, not for active synovitis with preserved joint surfaces. Arthroscopic synovectomy is effective but less durable and requires prolonged factor coverage. Amputation is not indicated.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.