Arthroscopic Synovectomy of the Wrist in Rheumatoid Arthritis / 대한정형외과학회잡지

ABSTRACT

PURPOSE: We evaluated the therapeutic effectiveness of arthroscopic synovectomy in patients with rheumatoid wrists. MATERIALS AND METHODS: Nineteen wrists in 18 patients (4 males and 14 females, average age 49.2 years) who had not responded to anti-rheumatic medications, were treated with arthroscopic synovectomy. Patients 'subjective symptoms were evaluated using a visual analogue scale for pain and satisfaction. Standard posteroanterior radiographs taken preoperatively and at the final follow up were ana-lyzed using the modified Larsen/Rau score system (normal, 0; total destruction, 40). The average follow up period was 29.5 months. RESULTS: The mean preoperative pain score was 8.6 and this decreased to 3.6 one year after the operation, but increased to 4.4 at the final follow-up, suggesting a tendency of pain aggravation with time. The average satisfaction score at the final follow up was 6.3. The mean modi-fied Larsen/Rau score was 6.1 preoperatively and this increased to 8.4 at the final radiographs, demonstrating the slow progression of degen-erative changes. The severity of joint degeneration showed no correlation with the postoperative results. CONCLUSION: Arthroscopic synovectomy of rheumatoid wrists results in an effective reduction of pain and high satisfaction. Prolonged bene-fit should be observed by long term follow-up.