RESUMO
PIP joints, MCP joints and wrists of 80 patients with rheumatoid arthritis were operated on with late synovectomy. The rate of recurrence of local synovitis was about 5%, which contrasted favourably with a considerably higher rate of progression of bony erosions. The loss of range of movement was small to moderate. Pain was alleviated in most cases. The possibility of forecasting the results by preoperative parameters was limited. It was concluded that the main indication for late synovectomy of the hand was alleviation of pain. The prophylactic effect on joint destruction seemed to be both slight and unpredictable.
Assuntos
Artrite Reumatoide/cirurgia , Mãos , Sinovectomia , Adulto , Artrografia , Feminino , Seguimentos , Mãos/cirurgia , Deformidades Adquiridas da Mão/etiologia , Humanos , Articulações/cirurgia , Masculino , Pessoa de Meia-Idade , Movimento , Dor , Cuidados Pós-Operatórios , Complicações Pós-Operatórias , Recidiva , Sinovite/cirurgia , Ulna/cirurgia , Punho/cirurgiaRESUMO
Eighty-two patients subjected to late synovectomy of the hand were followed up. Late synovectomy was defined as an operation performed after at least 3 years' duration of local synovitis in the type of joint operated on. The minimum follow-up period was 24 months for the fingers joints (IP + PIP and MCP) and 18 months for the dorsal aspect of the wrist (W). The multifocal swelling of joints, preoperatively, was symmetrical in 89% of the patients. The X-ray changes, however, were symmetrical in only 22%, 27%, and 68% for IP + PIP, MCP, and W, respectively. These findings may preclude the use of controlled studies on early synovectomy using the non-operated hand as a control in a long-term assessment of X-ray progression. The rate of X-ray progression during the observation period was 60% for IP + PIP joints. The corresponding figures for MCP and W were 64% and 39%, respectively. Absence of bony lesions prior to synovectomy was favourable sign.
