Evaluation of arthroscopic synovectomy in treatment of rheumatoid arthritis

Objective To appraise the value of arthroscopic synovectomy in early and midstages rheumatoid arthritis. Methods 42 knees in 34 rheumatoid arthritis patients(24 knees of 22 early-stage cases, 18 knees of 12 mid-stage cases) were performed with arthroscopic synovectomy and received anti-rheumatoid drug therapy postoperatively. We used bipolar radiofrequency in treating 32 knees. All 42 knees were followed-up for 6 months, with 31 knees followed-up for 2 years, and 14 knees evaluated at 4-year after operation. All patients were evaluated by knee function, erythrocyte sedimentation rate (ESR), C reaction protein(CRP) and rheumatoid factor(RF). Results At 6 months postoperatively, the rate of excellent and good effects was 95.2%(40/42). At 2 years, 87.1% of knees (27/31) were considered to have excellent and good result, and at 4 year 64.3% of knees(9/14)continued to do well. ESR, CRP and RF significantly decreased postoperatively in early stage group(P0.05). Whereas in mid-stage group, CRP and RF also decreased significantly postoperatively (P0.05).Conclusions Satisfactory results can be obtained through arthroscopic synovectomy and concomitent anti-rheumatoid drug therapy in early and mid-stages rheumatoid arthritis. Bipolar radiofrequency is helpful in eliminating synovia, preventing knee joint hematoma and favoring rehabilitation.