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MR Vol.11 No3 indexに戻る
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MODERN RHEUMATOLOGY
Vol.11 No.3 |
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Follow-up results of arthroscopic synovectomy
for the rheumatoid knee |
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| S. Momohara1, M. Ikeda1, K. Uchida1, K.
Kawamura1, T. Mizumura1, T. Tomatsu1 |
| (1)Department of Orthopaedic Surgery, Institute
of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada-cho,
Shinjuku-ku, Tokyo 162-0054, Japan |
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| Abstract |
| Abstract Arthroscopic synovectomy (ASS) of
a rheumatoid knee is performed in cases of intractable synovitis.
This spares the articular cartilage, and is an effective and simple
treatment for chronic knee synovitis. This retrospective study
was performed to evaluate the outcome of surgical arthroscopy,
and study the clinical results in detail. A total of 160 knees,
in 138 patients, were assessed after a mean follow-up of 35 months.
There was a statistically significant improvement in pain, synovitis,
and walking ability for at least 24 months after surgery. Based
on the results of our study, age, duration of rheumatoid arthritis
(RA), and erythrocyte sedimentation rate (ESR) and level of C-reactive
protein (CRP) at surgery were not predictors of a poor long-term
outcome of ASS. However, the clinical results correlated with the
Lansbury index, loss of extension of the knee joint, a modified
Larsen score, and the Larsen grade of the knee joint. Of the cases
studied, total knee arthroplasty (TKA) was performed in 29 knee
joints. We concluded that although ASS can reduce local inflammation
and delay the need for definitive replacement surgery, patients
over 60 years of age who show severe radiographic changes should
undergo primary TKA. |
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| Key words |
| Key words Arthroscopy ・ Rheumatoid knee ・
Synovec-tomy ・ Total knee arthroplasty |
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