Suitability of the total arthroscopic synovectomy in treatment of the exudative inflammation of the knee joint in patients suffering from rheumatoid arthritis

Rheumatoid Arthritis (RA) is a chronic, immunologically-dependent systemic disease of the connective tissue. It is characterized by symmetric and long-lasting inflammation of synovial membrane. The disease affects peripheral joints, and out of large joints, the knee joint is most often affected. Synovectomy is one of the surgical methods supplementary to the pharmacological treatment. The total arthroscopic synovectomy has recently become more and more significant because of its minimal invasiveness, radicality and shortening of the therapy and rehabilitation time. This technique allows the synovial membrane to be removed out of 4 arthroscopic ports in a quite accurate way, and the indications for it are the recurrent exudates for a 6 months’ period. The aim of the study was to present early results and effectiveness of the total arthroscopic synovectomy performed in RA patients. The patients were evaluated after they had a total arthroscopic synovectomy surgery of the knee joint performed in the Rheumoorthopedics Department of the Institute of Rheumatology in Warsaw, in the years 2005-2006. The follow-up observation period was two years. The research was carried out on the basis of own examination charts, while the results were evaluated in accordance with functional tests by the HSS Knee Score (Hospital for Special Surgery) and Lysholm’s score. Out of 21 operated patients, 15 reported for examination. The functional assessment was carried out from 1/2 year up to 2 years after the total arthroscopic synovectomy had been done. It was found that excellent and good results were obtained in 80% of the examined patients in that period after the surgery. The results are comparable with the other medical faculties dealing with this problem in Europe and worldwide. The total arthroscopic synovectomy enables quick decision on rehabilitation and performance function of the knee joint, it shortens treatment time and reduces its costs and doses of basic medicines as well (Table I).