REVIEW - Arthroscopic synovectomy in RA of the wrist

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Clin Med Res. 2007 Dec;5(4):244-50. Epub 2007 Dec 17.

Arthroscopic synovectomy in rheumatoid arthritis of wrist.

Kim SJ, Jung KA.

Department of Orthopaedic Surgery, Yonsei University College of

Medicine, Seoul, Korea.

The wrist is the most commonly involved region of the upper extremity

in rheumatoid arthritis (RA). Because the wrist joint becomes involved

early during the disease course and its involvement rapidly

progresses, and because the disabilities associated with progressive

RA are significant, early and adequate treatment must be introduced to

prevent disease progression. Various treatment methods can be employed

to treat RA wrists based on radiological and clinical findings.

Arthroscopic synovectomy is recommended for pain relief and functional

recovery in early stage RA, and is also helpful in advanced staged RA

with Larsen stage III. However, arthroscopic synovectomy is not

recommended as an effective method of treatment for all patients with

advanced radiographic changes. Nevertheless, arthroscopic synovectomy

may delay the need for complex surgery, such as wrist arthrodesis or

total wrist arthroplasty in selective cases. Although arthroscopic

synovectomy of the wrist cannot improve grip strength or range of

motion, it can reduce wrist pain and improve function, and thus

facilitate return to work.

PMID: 18086905

http://www.ncbi.nlm.nih.gov/pubmed/18086905

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