Clinical Efficacy of Arthroscopic Synovectomy for Rheumatoid Knee_West China Medical Journal

Authors：

 WANGYong-cai , YANBing , WANGHong-chuan , LIUKai , JIANGJun-wei

Department of Orthopedics, People's Hospital of Leshan, Leshan, Sichuan 614000, P. R. China;

Corresponding author：

Keywords：

Knee joint; Rheumatoid arthritis; Arthroscopy; Synovectomy

DOI：

10.7507/1002-0179.20150124

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Objective To investigate the clinical outcome of arthroscopic synovectomy for inpatients with rheumatoid knee. Methods Arthroscopic synovectomy was performed on 32 rheumatoid knees in 31 patients, including 10 males and 21 females with an average age of (35.5±8.7) years (23 to 51 years) between January 2009 and March 2013. The patients' mean morbidity duration was (12.0±5.5) years (5 to 21 years). X-ray examination results were observed before the operation, 1 year and 2 years after the operation, and then Larsen method was used for assessment. Pain alleviation, C-reactive protein (CRP), rheumatoid factors (RF), and erythrocyte sedimentation rate (ESR) were compared before and after operation. Results The follow-up averaged 1.7 years, and the average pain score decreased from 4.23±0.96 before surgery to 2.21±0.87 one year after surgery; RF decreased from (265.3±120.1) U/mL to (89.2±12.1) U/mL; CRP decreased from (89.36±32.12) mg/L to (20.12±10.21) mg/L; and ESR decreased from (86.56±12.32) mm/h to (45.23±11.12) mm/h. Conclusion Arthroscopic synovectomy can effectively relieve pain and delay radiologic progression in patients with rheumatoid knees.

Citation： WANGYong-cai, YANBing, WANGHong-chuan, LIUKai, JIANGJun-wei. Clinical Efficacy of Arthroscopic Synovectomy for Rheumatoid Knee. West China Medical Journal, 2015, 30(3): 421-425. doi: 10.7507/1002-0179.20150124 Copy

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11.	Nakamura H, Nagashima M, Ishigami S, et al. The anti-rheumatic effect of multiple synovectomy in patients with refractory rheumatoid arthritis[J]. Int Orthop, 2000, 24(5):242-245.
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13.	Gibbons CE, Gosal HS, Bartlett J. Long-term results of arthroscopic synovectomy for seropositive rheumatoid arthritis:6-16 year review[J]. Int Orhtop, 2002, 26(2):98-100.
14.	吕厚山, 孙炜, 寇伯龙, 等. 滑膜切除术治疗膝类风湿关节炎45例短期随访报告[J]. 中华骨科杂志, 1996, 16(1):5-7.
15.	Ossyssek B, Anders S, Grifka J, et al. Surgical synovectomy decreases density of sensory nerve fibers in synovial tissue of non-inflamed controls and rheumatoid arthritis patients[J]. J Orthop Res, 2011, 29(2):297-302.
16.	Chin KR, Barr SJ, Winalski C, et al. Treatment of advanced primary and recurrent diffuse pigmented villonodular synovitis of the knee[J]. J Bone Joint Surg Am, 2002, 84(12):2192-2202.
17.	Nakamura H, Tanaka H, Yoshino S. Long-term results of multiple synovectomy for patients with refractory rheumatoid arthritis. Effects on disease activity and radiological progression[J]. Clin Exp Rheumatol, 2004, 22(2):151-157.
18.	王湘达, 吕成昱, 王英振, 等. 膝关节复发性色素沉着绒毛结节性滑膜炎的关节镜治疗[J]. 中华骨科杂志, 2004, 24(3):174-176.

1. Kirwan JR. The synovium in rheumatiod arthritia:evidence for (at least) two pathologies[J]. Arthritis Rheum, 2004, 50(1):1-4.
2. Tarner IH, Harle P, Muller-Ladner U, et al. The different stages of synovitis:acute vs chronic, early vs late and non-erosive vs erosive[J]. Best Pract Res Clin Rheumatol, 2005, 19(1):19-35.
3. 曾润铭, 张忠民, 金大地. 类风湿关节炎滑膜细胞向破骨细胞分化实验研究[J]. 中华风湿病学杂志, 2005, 9(3):149-153.
4. Arnett FC, Edworthy SM, Bloch DA, et al. The American rheumatism association 1987 revised criteria for the classification of rheumatoid arthritis[J]. Arthritis Rheum, 1988, 31(3):315-324.
5. Larsen A, Dale K, Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films[J]. Acta Radiol Diagn (Stockh), 1977, 18(4):481-491.
6. 赵立恒, 余家阔, 罗浩. 膝关节十分区法及其在类风湿关节炎关节镜下滑膜全切除除术中的应用[J]. 中国微创外科杂志, 2009(4):327-331.
7. van der Heijde D. Radiographic progression in rheumatoid arthritis:does it reflect outcome? Does it reflect treatment?[J]. Ann Rheum Dis, 2001, 60(Suppl 3):iii47-iii50.
8. Molenaar ET, Voskuyl AE, Dinant HJ, et al. Progression of radiologic damage in patients with rheumatoid arthritis in clinical remission[J]. Arthritis Rheum, 2004, 50(1):36-42.
9. Hitchon CA, El-Gabalawy HS. The synovium in rheumatoid arthritis[J]. Open Rheumatol J, 2001(5):107-114.
10. Kubacki J, Kokosz M, Grygorowicz M, et al. The value of synovectomy of the knee in the treatment of rheumatoid arthritis[J]. Orthop Traumatol Rehabil, 2006, 8(1):99-105.
11. Nakamura H, Nagashima M, Ishigami S, et al. The anti-rheumatic effect of multiple synovectomy in patients with refractory rheumatoid arthritis[J]. Int Orthop, 2000, 24(5):242-245.
12. Klug S, Wittmann G, Weseloh G. Arthroscopic synovectomy of the knee joint in early cases of rheumatoid arthritis:follow-up results of a multicenter study[J]. Arthroscopy, 2000, 16(3):262-267.
13. Gibbons CE, Gosal HS, Bartlett J. Long-term results of arthroscopic synovectomy for seropositive rheumatoid arthritis:6-16 year review[J]. Int Orhtop, 2002, 26(2):98-100.
14. 吕厚山, 孙炜, 寇伯龙, 等. 滑膜切除术治疗膝类风湿关节炎45例短期随访报告[J]. 中华骨科杂志, 1996, 16(1):5-7.
15. Ossyssek B, Anders S, Grifka J, et al. Surgical synovectomy decreases density of sensory nerve fibers in synovial tissue of non-inflamed controls and rheumatoid arthritis patients[J]. J Orthop Res, 2011, 29(2):297-302.
16. Chin KR, Barr SJ, Winalski C, et al. Treatment of advanced primary and recurrent diffuse pigmented villonodular synovitis of the knee[J]. J Bone Joint Surg Am, 2002, 84(12):2192-2202.
17. Nakamura H, Tanaka H, Yoshino S. Long-term results of multiple synovectomy for patients with refractory rheumatoid arthritis. Effects on disease activity and radiological progression[J]. Clin Exp Rheumatol, 2004, 22(2):151-157.
18. 王湘达, 吕成昱, 王英振, 等. 膝关节复发性色素沉着绒毛结节性滑膜炎的关节镜治疗[J]. 中华骨科杂志, 2004, 24(3):174-176.

West China Medical Journal

Clinical Efficacy of Arthroscopic Synovectomy for Rheumatoid Knee

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