COMPARISON BETWEEN ARTHROSCOPIC AND OPEN SYNOVECTOMY FOR THE RHEUMATOID KNEE - A RETROSPECTIVE STUDY ON THE RESULTS OF THE 2 METHODS

Patients with knee joints affected by rheumatoid (RA) were randomly se lected for either arthroscopic or open synovectomy, and the post-opera tive results were compared retrospectively. The 58 patients had a tota l of 75 surgically treated knees. Arthroscopic synovectomy was perform ed on 37 knees of 30 patients, who were followed on average for 5 year s and 4 months. Open synovectomy was performed on 38 knees of 28 patie nts, who were followed on average for 5 years and 5 months. The analys is included evaluation for: recurrence rate and recurrence time of syn ovitis; duration of symptom-free period; incidence of progressive bone changes on radiography; range of motion (ROM); duration of hospital s tay; and duration of surgery. In the arthroscopic synovectomy group, t here was no restriction of ROM after surgery, shorter hospital stay, a nd lower incidence of osteoarthritic changes. However, the effect of s urgery lasted for only 18 months on average and recurrence of synoviti s was observed in 73% of the patients. In the open synovectomy group, due to restricted ROM in some patients, post-operative treatment was r equired and the hospital stay tended to be longer. Nevertheless, the r ecurrence rate was only 37% during the follow-up period (p<0.01 compar ed to arthroscopic synovectomy group), and the effect of surgery persi sted for an average of 75 months, much longer than that in the arthros copic synovectomy group. In the treatment of RA knees, the indications for both arthroscopic and open synovectomy should be studied carefull y in the light of the strengths and limitations of each procedure.