Radiosynoviorthesis in People With Haemophilia—Pain‐Related and Clinical Outcomes: A Prospective Controlled Cohort Study

ABSTRACT Introduction Radiosynoviorthesis (RSO) may alleviate pain and clinical symptoms in people with haemophilia (PwH), however, controlled longitudinal data on these outcomes remain limited. Aim To evaluate the effects of RSO on pain, joint health, swelling, and treatment satisfaction over twelve months. Methods Patients with an indication for RSO ( n = 30) and patients without indication ( n = 33) were examined for subjective joint‐related pain (NRS), pressure pain thresholds (PPT), the Haemophilia Joint Health Score (HJHS), and joint swelling at baseline and three, six, and twelve months post‐RSO. RSO‐treated joints (J‐RSO, n = 33) were compared to the corresponding contralateral joint (J‐CL, n = 33), and joints of control PwH without RSO (J‐Con, n = 33). Results RSO was administered in 9 elbows, 6 knees, and 18 ankles. Over the twelve‐month follow‐up, no significant time x joint group interaction was observed for NRS between J‐RSO and J‐Con ( p = 0.092) or J‐CL ( p = 0.096). However, from baseline to three months, reduction in NRS was significantly more pronounced in J‐RSO compared to control joints. No significant differences in longitudinal changes were observed for PPT or HJHS. Swelling was significantly reduced in J‐RSO at three and six months (each p = 0.037), without significant differences compared to control joints. At twelve months, the majority of RSO‐treated patients (78.8%) reported treatment satisfaction. Conclusion RSO was associated with a greater early reduction in subjective joint‐related pain. Over the twelve‐month follow‐up, this gradually decreased, resulting in no significant difference in overall pain trajectory. Swelling decreased for six months only in J‐RSO, while PPT and HJHS showed no significant improvements in J‐RSO.