DMARDs and arthroscopic synovectomy for the treatment of rheumatoid arthritis

Objective To evaluate the administration of disease-modifying antirheumatic drugs (DMARDs) combined with arthroscopic synovectomy for patients with rheumatoid arthritis(RA). Methods Forty six patients with rheumatoid arthritis (52 knees) were treated with DMARDs combined with arthroscopic synovectomy. Compound betamethasone injection and sodium hyaluronate injection were administrated in the knee joints after operation, and DMARDs were given continuously. All the 52 knees were followed up for 6 months and 35 knees were followed up for 2 years. During the follow-up the joint pain was assessed with VAS scoring; knee function with Ishikawa's scoring system. Erythrocyte sedimentary rate (ESR), C-reactive protein (CRP) and rheumatoid factor (RF) were measured before and after operation. Results Tenderness and swelling of the knees were relieved in one week. The levels of ESR, CRP and RF were decreased significantly in the different period. The rate of excellent and good scores in Ishikawa's system was 94.2% 6 months after operation. Conclusion The short-term follow-up indicates that DMARDs combined with arthroscopic synovectomy are effective in the management of early and mid-stage rheumatoid arthritis.