Treatment for chronic synovitis of knee: arthroscopic or open synovectomy

Abstract

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.

Postinfektiöse reaktive Arthritis nach Chlamydieninfektion im Leistungssport

“…Einem Fünftel der Betroffenen droht sogar eine langfristige Chronifizierung [15]. Sollte sich das Erkrankungsbild trotz der o. g. Behandlung therapierefraktär zeigen, stellt die arthroskopische Synovialektomie eine invasive, aber erfolgversprechende therapeutische Option dar [4,28].…”

Medizinisches Vorgehen in der Orthopädischen Rheumatologie

“…Liegen keine extraartikulären Begleitpathologien vor, können Synovialektomien an fast allen Gelenken auch sehr effektiv arthroskopisch durchgeführt werden [6,[9][10][11][12]. Die Ergebnisse und Rezidivrate nach diesem Vorgehen können mit einer 6 Wochen postoperativ erfolgenden Radiosynoviorthese noch deutlich verbessert werden [13][14] Ebenfalls zu den gelenkerhaltenden Operationen gehören die knöchernen Umstellungsoperationen, z.…”

Improved quality of life and joint functions in patients with knee rheumatoid arthritis who underwent five portal arthroscopic synovectomy

“…Arthroscopic synovectomy can be performed through either five or six portal approach. Previous studies have demonstrated that five portal arthroscopic synovectomy, with only five small incisions made around the knee joint, could be as effective as open synovectomy for knee synovitis from various causes ( Pan et al, 2012 ; Kubat et al, 2010 ; Jain et al, 2013 ). The benefits of five portal arthroscopic synovectomy in the treatment of knee rheumatoid arthritis require further investigations.…”