Arthroscopic Debridement After Total Knee Arthroplasty Is More Effective for Synovitis Than for Ankylosis

Abstract

PurposeThe purpose of this study was to investigate the effects of arthroscopy surgery on ankylosis and synovitis post-TKA, with patient satisfaction as the main outcome measure. MethodsA single surgeon’s database from 2002-2024 was queried for all knee arthroscopy procedures done using ICD-9 and ICD-10 codes for ankylosis or synovitis and with CPT codes 29884 and 29876. Patients were excluded if they did not have a prior TKA, had a TKA but arthroscopy was done for multiple or other indications, were <2 months from TKA, lacked medical records, or were worker’s compensation cases. Patients were separated into either the ankylosis group or the synovitis group. A patient satisfaction survey was collected at first and last follow-up and asked individuals to rate their condition as “Better”, “Unchanged”, or “Worse” after arthroscopy. A total of 199 subjects were included: 48 in the ankylosis group and 151 in the synovitis group. ResultsThe mean initial follow-up time was 5.2 and 7.2 months for the ankylosis and synovitis groups, respectively. Mean final follow-up time was 3.7 and 4.8 years, respectively. For initial follow-up, the ankylosis group reported 31% better, 56% unchanged, 13% worse while the synovitis group reported 69% better, 29% unchanged, and 2% worse (P < .001). For final follow-up, the ankylosis group reported 44% better, 41% unchanged, and 15% worse while the synovitis group reported 78% better, 10% unchanged, and 12% worse (P < .001). ConclusionAfter TKA, arthroscopic surgery can reduce symptoms and improve satisfaction for patients with ankylosis or synovitis. Patient satisfaction is improved in a higher percentage of patients with synovitis compared with ankylosis.