Treatment of rheumatoid gonarthritis by arthroscopic synovectomy combined with radiofrequency vaporization / 中国微创外科杂志

ABSTRACT

Objective To investigate clinical effects of arthroscopic synovectomy combined with radiofrequency vaporization for the treatment of rheumatoid synovitis of the knee joint.Methods In 36 cases of rheumatoid gonarthritis with chronic synovitis of the knee joint,with simultaneous administration of regular medication,we had applied arthroscopic synovectomy combined with radiofrequency vaporization to remove the hyperplastic synovium and pannus through standard anteromedial and anterolateral approaches, and superolateral and superomedial approaches.In 21 out of 36 cases,diseased synovium in the posterior compartment was resected via additional posteromedial and posterolateral approaches.A systematic rehabilitation program was practiced 3 days after operation. Results All the 36 cases were followed for 4~26 months(mean,16 months).Clinical effects evaluation showed "excellent" in 21 cases,"good" in 13 cases,and "fair" in 2,with a total excellent-or-good rate of 94.4%(34/36).The knee joint function scores were significantly elevated from 58.6?5.3 preoperatively to 91.6?5.8 postoperatively(t=2.723,P=0.003).The Lysholm scores were significantly elevated from 42.3?3.8 preoperatively to 90.2?4.4 postoperatively(t=2.437,P=0.001).Conclusions Combined use of arthroscopic synovectomy with radiofrequency vaporization for the treatment of rheumatoid gonarthritis has advantages of minimal trauma,little blood loss,and rapid recovery of joint function.The procedure can effectively control the progression of rheumatoid arthritis and restore the knee joint function to the greatest possible extent.