RESEARCH - Long-term follow-up results of synovectomy for RA

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Nan Fang Yi Ke Da Xue Xue Bao. 2006 Jun;26(6):867-9. Links

[Long-term follow-up results of synovectomy for rheumatoid

knee][Article in Chinese]

Zeng RM, Zou YC, Lin J, Zhao ZJ, Liu MZ, Li WM.

Department of Orthopedics, First Clinical College of Shantou

University, Shantou 515041, China.

OBJECTIVE: To continuously observe the long-term effects of

synovectomy for improving joint damage and quality-of-life in patients

with the rheumatoid knee. METHODS: Twenty-one consecutive patients

with rheumatoid arthritis (RA) involving 24 knees underwent open

synovectomy from November 1988 to January 1997 between November 1988

and January 1997. The changes in radiographic damage were assessed

with Larsen score on plain films before and 6 months after surgery

with subsequent annual assessment for 8 years, and the functional

recovery of the patients was also evaluated with Health Assessment

Questionnaire (HAQ) at the same time. RESULTS: The radiographic joint

damage and juxta-articular osteoporosis or bone erosion was

ameliorated after surgery in all the patients. Larsen score began to

decrease 6 months after the operation, and the best effects were

achieved at one year and maintained for at least 5 years after the

operation, but then followed by recurrence of joint lesions. HAQ

scores were improved after the surgery with the best effects observed

6 months after the operation lasting for over 2 years. HAQ score

gradually decreased 4 years after the operation till reaching the

preoperative scores.

CONCLUSION: Synovectomy in the patients with rheumatoid knee not only

reverses progressive joint damage, but also improves juxta-articular

bone erosions and the patients' quality of life. However, radiographic

joint damage and functional deterioration may recur due to hyperplasia

of the inflammatory synovium in the long term after operation,

suggesting that the inflammatory synovium participates in local joint

damage with bone erosions and systemic pathologic process of RA.

PMID: 16793624

http://www.ncbi.nlm.nih.gov/pubmed/16793624

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