Document Detail

Arthroscopic synovectomy for rheumatoid wrists and elbows.
MedLine Citation:
PMID:  22933683     Owner:  NLM     Status:  In-Data-Review    
PURPOSE. To evaluate the treatment outcome of wrist and elbow arthroscopic synovectomy for patients with rheumatoid arthritis. METHODS. 3 men and 18 women aged 27 to 71 (mean, 54) years underwent arthroscopic synovectomy for rheumatoid arthritis of the wrist (n=12) and elbow (n=13). All patients had received multiple medications including non-steroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs, and steroids, as well as physiotherapy and splintage for 6 months, but the joint pain and disability persisted. The median duration of rheumatoid arthritis was 89 (range, 24-156) and 108 (range, 36-360) months for the wrist and elbow joints, respectively. According to the Larsen grading, the radiographic stages of the wrists and elbows were classified as grade 1 (n=4+4), grade 2 (n=4+5), and grade 3 (n=4+4). Visual analogue scale for pain, the wrist and elbow flexion-extension arcs, grip strength, key pinch strength, inflammatory markers, disability and symptoms were compared pre- and post-operatively. RESULTS. The median follow-up period was 30 (range, 18-78) and 34 (range, 18-78) months for wrists and elbows, respectively. There was significant improvement in pain, joint motion, inflammatory markers, and disability score. All patients were satisfied with the surgery. There was no neurovascular or wound complication. No patient was taking longterm pain-control drugs. One patient underwent a second arthroscopic synovectomy after 15 months owing to exacerbation of arthritis. CONCLUSION. Arthroscopic synovectomy is recommended for patients with rheumatoid arthritis who fail conservative treatment.
Cy S Chung; C H Yen; Ml R Yip; Sc Jj Koo; Wn V Lao
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of orthopaedic surgery (Hong Kong)     Volume:  20     ISSN:  1022-5536     ISO Abbreviation:  J Orthop Surg (Hong Kong)     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9440382     Medline TA:  J Orthop Surg (Hong Kong)     Country:  China    
Other Details:
Languages:  eng     Pagination:  219-23     Citation Subset:  IM    
Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong.
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