J Korean Orthop Assoc.
2002 Oct;37(5):633-637.
Arthroscopic Synovectomy of the Wrist in Rheumatoid Arthritis
- Affiliations
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- 1Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. mjp@smc.samsung.co.kr
Abstract
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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.
