Five to nine year follow-up results of arthroscopic synovectomy of the knee in rheumatoid patients

Abstract

The results of arthroscopic synovectomy in rheumatoid knees were examined. Forty-nine knees of 44 patients (17 knees of males and 32 knees of females) with an average age of 55.9 years at the time of operation were examined. The average postoperative observation period was 6.4 years. Arthroscopic synovectomy was carried out by using a shaver and a punch. In the final examination, 72% of the cases showed good or excellent results. The clinical results at the final examination were inferior in cases where the preoperative roentgenographic classification and the degree of cartilage damage were more than Larsen II and grade 2, respectively. The preoperative erythrocyte sedimentation rate was found to be correlated with the postoperative clinical results. Postoperative results were poor in cases with a preoperative flexion contracture of 15° or more. A comparison of preoperative and postoperative X-ray findings showed aggravation in 47 of the 49 knees. The results indicate that arthroscopic synovectomy may be effective for early-stage cases, in which rheumatoid arthritis is well controlled and there is no flexion contracture. However, the results also suggest that this operation is not effective for stopping articular destruction.