REVIEW - The value of synovectomy of the knee in the treatment of RA

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Ortop Traumatol Rehabil. 2006 Feb 28;8(1):99-105.

The value of synovectomy of the knee in the treatment of rheumatoid arthritis.

Kubacki J, Kokosz M, Grygorowicz M, Adamczyk-Bujniewicz H.

Katedra Podstaw Fizjoterapii, Wydzia³ Fizjoterapii AWF, Katowice.

The goal of the present study is to evaluate the usefulness of

synovectomy of the knee joint in patients with rheumatoid arthritis.

Synovectomy of the knee is the most common lower limb operation

performed in patients with rheumatoid arthritis. Depending on the

stage of the disease, the symptoms, and the degree of intra-articular

changes in the radiological image, there are indications for

performing both early and late synovectomy. The progress of the

disease is not dependent on its duration, but on the aggressiveness

and dynamics of the rheumatoid process. The authors present the

advantages of early synovectomy, which halts the progress of the

disease and protects the joint from destruction. After early

synovectomy one obtains an average of 75% good outcomes, while after

late synovectomy the percentage of positive outcomes is about 70%. The

authors point out the effectiveness and low level of invasiveness of

arthroscopic synovectomy, thanks to which the progress of the disease

can be checked and monitored. Another possible therapy is chemical

synovectomy, with the specific action of radioisotopes: synoviorthosis

with laser irradiation. The authors emphasize that an important factor

in obtaining good outcome after every synovectomy is rehabilitation,

during which the range, frequency of exercise, and physicotherapeutic

procedures are established, depending on the stage of advancement of

the rheumatoid process.

PMID: 17603463

http://www.ncbi.nlm.nih.gov/pubmed/17603463

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