[1] Few well-designed prospective double-blinded trials have evaluated the efficacy of the technique[2-4]; however, review of these studies and numerous smaller non-randomized studies suggest response rates in the range of 40–90%.[5-8] Since the early to mid 2000s, there has been a steady increase in the availability of new generation biological disease modifying medications this website which have had a major impact on disease control in inflammatory arthropathies such as rheumatoid arthritis, psoriatic arthritis and ankylosing spondylitis. Infliximab and etanercept became available on the Australian Pharmaceutical Benefits Scheme in 2003

followed by adalimumab and anakinra in 2004 and abatacept and rituxumab from 2007. Adalimumab and etanarcept remain the most commonly prescribed biologic disease modifiers and were introduced for mainstream use at our institution in 2005. Prior to this, commonly used disease modifiers included methotrexate, leflunamide, sulfasalazine and hydroxychloroquine, and to a lesser extent azathioprine and gold injections. For hemophilic arthropathy, there have also been new developments with the introduction of widespread recombinant factor replacement in 2005. Despite these

developments, a small subset of patients continue Wnt inhibitor to experience refractory, difficult to manage synovitis. Studies prior to the introduction of mainstream factor replacement therapy in hemophilia patients have demonstrated yttrium synovectomy can offer a conservative alternative to surgical synovectomy in patients with refractory hemophilic arthropathy with evidence that it produces equivalent results, costs less, allows the patient to remain ambulatory and is repeatable.[9, 10] The aim Phospholipase D1 of this study was to determine the clinical response rate to yttrium synovectomy across a variety of arthropathies in an era of improved disease modifying anti-rheumatic drugs (DMARDs)

and readily available factor replacement therapy and to evaluate whether response is sustained at 36 months in patients who initially respond. Following approval by the Alfred Hospital institutional ethics committee, the medical records which included relevant diagnostic imaging and biochemistry results of 119 (45 female, 74 male) patients, mean age 52 years (range 24–88), consecutively referred for yttrium synovectomy between January 2000 and December 2010 were retrospectively reviewed. Of these 119 patients, 167 joints in total (131 knees, 16 ankles, 19 elbows, 1 hip) were injected. Arthropathy type and duration, joint(s) injected, past and current treatments/medications and information relating to the degree of joint pain, swelling and range of movement pre- and post-yttrium synovectomy were collected.