The Role of Synovectomy in Total Knee Arthroplasty: A Prospective Analysis of 30 Cases

Abstract

AIM AND OBJECTIVESAim and objective of this study is to assess role of synovectomy during TKR on joint effusion, haemarthrosis, patellar clunk, recurrent synovitis, and histopathological diagnosis in patients undergoing Total Knee Arthroplasty (TKA). MATERIAL AND METHODSWe studied prospectively 30 patients with osteoarthritis of knee treated with total knee arthroplasty with near-total synovectomy. Patients were in the age group 55-70 years. The overall efficacy of both procedures was assessed postoperatively by determination of blood loss from the drain, pain, and Lysholm knee functional score. RESULTSAll 30 patients have been followed up for an average of 3 years for assessment for postoperative pain, knee joint effusion, patellar clunk, range of movement, and stability of prosthesis. During the postoperative 48 hours, the mean blood loss was slightly higher. To conclude, supplementing near-total synovectomy along with TKA may provide complete pathological diagnosis, beneficial in inflammatory arthritis, and some special synovial pathology like pigmented villonodular synovitis, rheumatoid arthritis, tuberculous arthritis, and haemophilic arthritis. Better long-term pain relief and functional outcome due to the removal of pathological synovium have been observed after synovectomy along with total knee arthroplasty. CONCLUSIONPerforming synovectomy in TKA will give complete pathological diagnosis, avoiding persistence of synovial pathology along with long-term benefits of synovectomy in the form of minimal to no joint effusion, less pain, absence of synovial hypertrophy, patellar clunk, and good range of movement of knee.