ARTHROSCOPIC AND RADIOGRAPHIC EXAMINATION OF PATIENTS WITH JUVENILE RHEUMATOID-ARTHRITIS BEFORE AND AFTER OPEN SYNOVECTOMY OF THE KNEE-JOINT - A PROSPECTIVE-STUDY WITH A 5-YEAR FOLLOW-UP

In a 5-year follow-up after open knee joint synovectomy in 18 patients with juvenile rheumatoid arthritis (JRA) there was no radiographic pr ogression of the juvenile rheumatoid arthritic changes. Radiographic e vidence indicative of osteoarthrosis and of the soft tissue swelling w ere scored separately. Radiographic changes consistent with osteoarthr osis increased significantly during the observation period (P < 0.001) . Arthroscopic evaluation of cartilage changes and radiographic evalua tion of osteoarthrosis correlated significantly (P = 0.004). These wer e the only parameters found predicting the development of further cart ilage destruction (P = 0.001). Clinically, the patients had significan t improvement five years following synovectomy (P = 0.018), even thoug h three patients required resynovectomy (one successfully after four y ears, and two patients are waiting for resynovectomy). At the 5-year f ollow-up both radiographic and clinical data indicate that juvenile rh eumatoid arthritic activity of the knee joint was reduced following op en synovectomy while osteoarthrosis developed. A new system of scoring radiographic JRA changes of the knee joint was found useful.