Arthroscopic versus open synovectomy in the rheumatoid knee

Matsui, Nobuo; Taneda, Y; Ohta, Hiroyuki; Itoh, Takashi; Tsuboguchi, S.

doi:10.1007/bf00266717

Cited by 48 publications

(27 citation statements)

References 5 publications

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“…Many studies have demonstrated that synovectomy can effectively relieve the symptom and improve the function of the affected joints because of removing actively inflamed synovium [1][2][3][4]. Open synovectomy is the traditional effective surgery in treating chronic synovitis.…”

Section: Introductionmentioning

confidence: 99%

Treatment for chronic synovitis of knee: arthroscopic or open synovectomy

et al. 2011

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Chronic synovitis of knee joints that cannot be treated by conservative measure effectively can be treated successfully by the operations through resecting the inflamed synovium. The operations include open synovectomy and arthroscopic synovectomy. The purpose of this study is to compare the two operations in alleviating symptoms and cosmetic effect. There were 42 patients in this study, and they suffered from chronic synovitis of knee joints, including rheumatoid arthritis and non-specific synovitis. Twenty-two knees of 22 patients underwent arthroscopic synovectomy with two to five approaches whose lengths were about 1.0 cm, and 20 knees of 20 patients underwent open synovectomy with two approaches whose lengths were more than 10.0 cm. Patients were evaluated by visual analog scale for pain at the 24th hour after operation. Patients were followed up for 16-20 months and were evaluated by the Ogilvie-Harris scoring system. This study showed that both arthroscopic synovectomy and open synovectomy successfully alleviated the symptoms and the short-term results are similar after operation. However, the scars in the patients of the former group were much shorter than the latter group. Pain intensity of patients underwent arthroscopic synovectomy was less than that of open synovectomy at the 24th hour after operation. Both operations could treat chronic synovitis successfully. However, the arthroscopic synovectomy is the preferred operation due to fast recovery, less postoperative pain, and excellent cosmetic effect.

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Section: Introductionmentioning

confidence: 99%

Treatment for chronic synovitis of knee: arthroscopic or open synovectomy

et al. 2011

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“…The use of arthroscopic synovectomy in rheumatoid arthritis allows the removal of inflamed synovium with minimal morbidity and decreased hospital stay [6]. Ogilvie-Harris has reported the results of arthroscopic synovectomy on 96 knees with rheumatoid arthritis, with 76% of knees being free from moderate or severe synovitis and with a significant reduction of pain at 4-year follow-up.…”

Section: Discussionmentioning

confidence: 99%

“…Long-term studies using the open technique are well documented but few papers describing the arthroscopic technique involve studies longer than 5 years [8]. The advantages of the arthroscopic technique include small scars resulting in a more rapid postoperative rehabilitation, and some reports record a greater postoperative range of movement [6,12]. Disadvantages include technical difficulties in accessing certain areas of inflamed synovium in the knee and are associated with a steep learning curve for this procedure.…”

Section: Introductionmentioning

confidence: 99%

Long-term results of arthroscopic synovectomy for seropositive rheumatoid arthritis: 6-16 year review

Gibbons¹,

Gosal

Bartlett³

2002

International Orthopaedics

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We prospectively studied a consecutive series of 25 knees (21 patients) treated with arthroscopic synovectomy for seropositive rheumatoid arthritis. All patients had pain and swelling and were in the early stages of the disease process (Larsen grade 2 or less). Three patients were lost to follow-up. At a mean of 8 years from operation two knees underwent total knee replacement with another two knees required a further arthroscopic synovectomy. One patient continued to experience intermittent mild synovitis. The range of movement was maintained or improved by surgery in 73% of cases but radiological evidence of degenerative change was seen in all knees. We discuss the technical difficulties associated with arthroscopic synovectomy that were associated with a small complication rate. In appropriately selected patients unresponsive to medical therapy, arthroscopic synovectomy can give safe and reliable results.Résumé Nous avons étudié une série consécutive de 25 genoux (21 malades) traités par une synovectomie arthroscopique pour polyarthrite rhumato séro-positive. Tous les patients avaient douleurs et èpenchement et étaient dans les stades précoces de la maladie (Larsen stade 2 ou moins). Trois patients ont été perdus de vue. À une moyenne de 8 ans aprés l'opération deux genoux ont eu une prothèse totale et deux genoux nécessitent une synovectomie arthroscopique supplémentaire. Un patient reste avec une synovite intermittente de faible intensité. L'amplitude de mouvement a été maintenue ou améliorée par la chirurgie dans 73% de cas, mais tous les genoux ont des signes radiologiques dégénératifs. Nous discutons les difficultés techniques de la synovectomie arthroscopique qui a été associée à un faible taux de complications. Chez les patients mauvais répondeurs à la thérapie médicale la synovectomie arthroscopique peut donner, avec peu de risques, des résultats fiables.

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“…However, the arthroscopic synovectomy is the preferred operation due to faster recovery, which reduces the duration of hospital stay and enables the earlier recovery of function in the operated joint, with the resultant effect of less postoperative pain, less bleeding and excellent cosmetic effect. [66][67][68] Some of the literature contains conflicting reports of the clinical results of rheumatoid knee synovectomy. In 1988, A controlled multi-centre evaluation of open surgical synovectomy in the treatment of RA was carried out over a period of 5 years after the operation.…”

Section: Kneementioning

confidence: 99%