Knee synovectomy in children with juvenile idiopathic arthritis

An up-to-date opinion is provided on benefit-risk balance associated with various methods of treatment in children with idiopathic juvenile arthritis. The objective of this study was to assess long-term outcome of knee joint synovectomy in a group of patients with juvenile rheumatoid arthritis and to present the authors’ view on this approach. The authors concentrated on surgical methods which should allow painless rehabilitation and quick recovery of the correct knee function with good mobility. The challenge of providing anaesthesia for longer and more complex surgery in children with idiopathic juvenile arthritis is a reality. In conclusion, we may say that knee synovectomy is an effective method for fighting effusion involving knee inflammation in JIA. It must be stressed however that results of the treatment strongly depend on the decision time and the advancement of the disease. According to our experience, we do not agree with the view of some authors that surgical intervention is not indicated until erosions are radiologically manifested; the state of low disease activity is also preferred for surgical intervention.