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Arthroscopic Synovectomy of the Ankle in Rheumatoid Arthritis

Authors
 Woo Jin Choi  ;  Gi Won Choi  ;  Jin Woo Lee 
Citation
 ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY, Vol.29(1) : 133-140, 2013 
Journal Title
 ARTHROSCOPY-THE JOURNAL OF ARTHROSCOPIC AND RELATED SURGERY 
ISSN
 0749-8063 
Issue Date
2013
MeSH
Adult ; Aged ; Aged, 80 and over ; Ankle Joint/diagnostic imaging ; Ankle Joint/surgery* ; Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/diagnostic imaging ; Arthritis, Rheumatoid/drug therapy ; Arthritis, Rheumatoid/surgery* ; Arthroscopy/methods* ; Arthroscopy/statistics & numerical data ; Blood Sedimentation ; C-Reactive Protein/analysis ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Pain Measurement ; Prognosis ; Radiography ; Range of Motion, Articular ; Recovery of Function ; Retrospective Studies ; Severity of Illness Index ; Synovectomy* ; Treatment Outcome
Keywords
Adult ; Aged ; Aged, 80 and over ; Ankle Joint/diagnostic imaging ; Ankle Joint/surgery* ; Antirheumatic Agents/therapeutic use ; Arthritis, Rheumatoid/diagnostic imaging ; Arthritis, Rheumatoid/drug therapy ; Arthritis, Rheumatoid/surgery* ; Arthroscopy/methods* ; Arthroscopy/statistics & numerical data ; Blood Sedimentation ; C-Reactive Protein/analysis ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Pain Measurement ; Prognosis ; Radiography ; Range of Motion, Articular ; Recovery of Function ; Retrospective Studies ; Severity of Illness Index ; Synovectomy* ; Treatment Outcome
Abstract
PURPOSE: To evaluate the outcome of arthroscopic synovectomy of the ankle joint in patients with early-stage rheumatoid arthritis (RA). METHODS: Between 2005 and 2009, 18 consecutive patients with RA involving the ankle underwent arthroscopic synovectomy. Pain was measured using a visual analog scale (VAS), and clinical outcome was determined by calculating the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale score with a mean follow-up of 5 years (60 months). Assessments were performed preoperatively, at 6 and 12 months postoperatively, and then yearly thereafter. Clinical success was defined as the absence of synovitis symptoms or when patients demonstrated good or excellent outcomes (AOFAS Ankle-Hindfoot Scale score ≥80) with >50% improvement in VAS score for pain. Demographic, laboratory, and radiological variables were evaluated to determine possible factors predicting clinical outcome. RESULTS: VAS and AOFAS scores were significantly improved at the final follow-up (60 months; P < .0001). The greatest improvements in clinical scores were observed after 12 months; thereafter, they steadily declined. Of the 18 patients examined, 14 (77.8%) were considered to have had clinical success with no reintervention. Variables predictive of clinical success were short duration of symptoms (P = .042) and minimal radiographic changes based on the Larsen grading system (P = .030). CONCLUSIONS: Arthroscopic synovectomy is a safe and successful procedure in ankle joints affected by RA. The best clinical outcomes are achieved when the procedure is performed early in the disease course and when there is no evidence of cartilage degeneration. LEVEL OF EVIDENCE: Level IV, prognostic case series.
Full Text
http://www.sciencedirect.com/science/article/pii/S0749806312015873
DOI
10.1016/j.arthro.2012.06.018
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Jin Woo(이진우) ORCID logo https://orcid.org/0000-0002-0293-9017
Choi, Woo Jin(최우진)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/86204
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