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The therapeutic outcome of minimally invasive synovectomy assisted with arthroscopy in the rheumatoid knee.

Ogawa H, Itokazu M, Ito Y, Fukuta M, Shimizu K

Department of Orthopaedic Surgery, Hikone Municipal Hospital, 1882 Hassaka, Hikone, Shiga 522-0057, Japan. h-ogawa@k7.dion.ne.jp

The purpose of the present study was to retrospectively evaluate the therapeutic outcome of minimally invasive synovectomy assisted with arthroscopy (MISAA). From 1995 to 2003, MISAA was performed on 30 knees of 18 rheumatoid arthritis patients. The mean follow-up period was 74.4 months. Radiographic assessment according to Larsen's radiological classification, the conversion ratio to total knee arthroplasty (TKA), and postoperative change of the range of flexion were evaluated retrospectively. There were 10 knees in grade I, 14 knees in grade II, and 6 knees in grade III, preoperatively. All the knees in grade I and 8 of 14 knees in grade II maintained the same grade until the latest follow-up. The other 6 knees in grade II and all the knees in grade III deteriorated to grade IV and were converted to TKA after MISAA. The mean range of flexion significantly increased postoperatively except the knees that were converted to TKA. MISAA is effective for rheumatoid knees in grade I or II, and improves range of flexion.

Published 13 December 2006 in Mod Rheumatol, 16(6): 360-3.
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Out of Joint: A Private and Public Story of Arthritis (American Lives)