Abstract
BackgroundMany studies have proposed synovectomy during total knee arthroplasty (TKA) to reduce pain after TKA. The aim of this study was to assess the outcomes of synovectomy for treating of TKA through a meta-analysis.MethodsRelevant clinical studies on synovectomy and without synovectomy were retrieved through searching the databases PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials up to January 2018. Studies that investigated the comparison of pain scores, total blood loss, range of motion, functional Knee Society Scores (KSSs), clinical KSSs, and operating time and provided sufficient data of interest were included in this meta-analysis. Stata 12.0 was used for meta-analysis.ResultsTen randomized controlled trials (RCTs) were finally included in this meta-analysis. Final results indicated that there was no significant difference between the pain scores, range of motion, functional Knee Society Scores (KSSs), and clinical KSSs (P > 0.05). However, synovectomy was associated with an increase of the total blood loss compared to patients without synovectomy (weighted mean difference (WMD) = 116.71, 95% confidence interval (CI) 78.63, 154.79, P = 0.000). Pooled results indicated that synovectomy was associated with an increase of the operating time (WMD = 15.44, 95% CI 2.67, 28.21, P = 0.018).ConclusionsCurrent evidence indicates that synovectomy has no effects on the final clinical outcomes for patients undergoing TKA. It will increase the total blood loss and the operating time during TKA.
Highlights
Many studies have proposed synovectomy during total knee arthroplasty (TKA) to reduce pain after TKA
Seven studies refer to the random sequence generation and the rest three studies did not state the random sequence generation and identify as unclear risk of bias
Clinical Knee Society Score (KSS) Clinical KSSs were reported in seven studies, and the pooled results indicated that there was no significant difference between the synovectomy group and control group in terms of the clinical KSS (WMD = 1.12, 95% confidence interval (CI) − 1.04, with an increase of the operating time (WMD = 15.44, 3.28, P = 0.310, Fig. 7)
Summary
Many studies have proposed synovectomy during total knee arthroplasty (TKA) to reduce pain after TKA. Synovectomy when in total knee arthroplasty (TKA) for primary OA, excising the inflamed or proliferated synovial membrane, reduces pain and improves joint function and is beneficial for patients with RA and other inflammatory disease [2]. Many inflammatory cytokines have been isolated from the knee and the blood in patients with moderate to severe primary osteoarthritis, [3] the benefit of synovectomy as a sole procedure in OA remains unclear. Synovitis has been reported as one of several contributing factors in unsatisfactory results after TKA [7] This raises the question as to whether intraoperative synovectomy during TKR would be advantageous in decreasing postoperative inflammation of the knee
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