Survival analysis and longterm results of elbow synovectomy in rheumatoid arthritis (original) (raw)
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Synovectomy of the elbow in rheumatoid arthritis. Long-term results
The Bone & Joint Journal
We reviewed 61 elbow synovectomies in 50 patients with rheumatoid arthritis, with follow-up varying from 4 to 10 years (mean 6.5 years). The results were graded as satisfactory in 70%, with no significant difference in the results between joints which were radiologically good before operation and those which had been destroyed. Longer term results were analysed of 27 elbow synovectomies in 22 patients followed up for over six years. The results were satisfactory in 67% of the patients in both 1981 and in 1987, with no deterioration over this period.
Arthroscopic Synovectomy for Rheumatoid Wrists and Elbows
Journal of Orthopaedic Surgery, 2012
purpose. To evaluate the treatment outcome of wrist and elbow arthroscopic synovectomy for patients with rheumatoid arthritis. Methods. 3 men and 18 women aged 27 to 71 (mean, 54) years underwent arthroscopic synovectomy for rheumatoid arthritis of the wrist (n=12) and elbow (n=13). All patients had received multiple medications including non-steroidal anti-inflammatory drugs, disease-modifying anti-rheumatic drugs, and steroids, as well as physiotherapy and splintage for 6 months, but the joint pain and disability persisted. The median duration of rheumatoid arthritis was 89 (range, 24-156) and 108 (range, 36-360) months for the wrist and elbow joints, respectively. According to the Larsen grading, the radiographic stages of the wrists and elbows were classified as grade 1 (n=4+4), grade 2 (n=4+5), and grade 3 (n=4+4). Visual analogue scale for pain, the wrist and elbow flexion-extension arcs, grip strength, key pinch strength, inflammatory markers, disability and symptoms were compared
Arthroscopic synovectomy of the knee joint for rheumatoid arthritis
International Orthopaedics, 2018
Objective To investigate the effect of knee arthroscopic synovectomy (AS) on the disease activity, quality-of-life (QoL), and the functional status of patients with rheumatoid arthritis (RA). Materials and methods A retrospective analysis was conducted on the outcomes of AS performed on 138 RA patients; presurgery assessments were done using Disease Activity score (DAS 28) and Routine Assessment of Patient Index Data З (RAPID-3) on а multidimensional health-assessment questionnaire for disease activity, EuroQol-5D (EQ-5D) and the Short-Form Medical Outcomes Study (SF-36) for quality of life, and the Health Assessment Questionnaire (HAQ) for functional status. The pain response to SA was measured by а visual analogue score (VAS) and the Knee Society Score (KSS). Results All parameters assessed in the study showed significant positive changes: the activity of the disease decreased, and patients' functional status and QoL improved. Conclusion AS is effective treatment for recurrent synovitis of the knee in RA patients. This technique improves the functional status of patients and their quality of life and reduces the activity of the disease.
International Journal of Medical Reviews, 2020
Aim: Few studies have been published about early surgical treatment of Rheumatoid Arthritis (RA). This article has aimed to describe the main procedures that may be performed in the hands of subjects at early stages of this disease. Methods: This research was a narrative review seeking comparative works in the Medline, LILACs and EMBASE databases. Results: The publications showed good results associated with wrist synovectomy. There was a reduction in pain, greater patient satisfaction, and stabilization of the Larsen score. Synovectomy was indicated in these studies as an alternative procedure after three to four months of unsatisfactory clinical therapy. Another possibility of approaching these patients is the repair or transfer of ruptured tendons. Most studies have described this procedure in patients already with deformities secondary to RA and not in the initial phase of the disease. In this group of patients, the authors observed that the highest number of ruptures was asso...
Results of dorsal wrist synovectomies in the rheumatoid hand
Journal of Hand Surgery-american Volume, 1990
Seventy-eight patients with rheumatoid arthritis had 102 dorsal wrist tenosynovectomies, intraarticular synovectomies, and Darrach resection from 1962 to 1982. Follow-up after surgery averaged 11 years, with a range from 3 to 20 years. Pain was diminished in all but 17 wrists and motion decreased an average of 13 degrees. Synovitis recurred in 16 wrists and x-ray evidence of progressive intraarticular destruction was seen in 45 wrists. Revision surgery was necessary in 28 wrists.
Total elbow arthroplasty in rheumatoid arthritis
Acta Orthopaedica, 2009
Background and purpose Although total elbow arthroplasty (TEA) is a recognized procedure for the treatment of the painful arthritic elbow, the choice of implant is still obscure. We evaluated the survival of different TEA designs and factors associated with survival using data from a nationwide arthroplasty register.
The Journal of Hand Surgery, 2010
Purpose Objective outcomes data after excision of the distal ulna in rheumatoid arthritis are lacking. The aim of this study was to evaluate the functional results of this surgery in the long term. Methods We prospectively collected data on range of motion (22 wrists), visual analog pain scores (14 wrists), and grip strength measured using a Jamar dynamometer (20 hands) in a group of 23 patients (26 wrists) preoperatively and at 3 months, 12 months, and a minimum of 5 years postoperatively (range, 5.3-10.4 y). The Jebsen-Taylor hand function test was administered to 9 patients at the same time points. A subgroup of patients also underwent extensor carpi radialis longus to extensor carpi ulnaris tendon transfer (11 wrists). Results At one year, there were improvements in wrist pronation and supination, which were maintained at final follow-up. Active radial deviation decreased significantly at 3 months (p ϭ .01) and one year (p ϭ .02); this remained reduced at final follow-up (not significant). Wrist extension and active ulnar deviation showed slight improvements by one year, but reduced to levels below that measured preoperatively by final follow-up. Wrist flexion was significantly reduced at all time points postoperatively. Grip strength showed improvement from 10.0 kg (standard deviation [SD] 4.1 kg) preoperatively to 12.5 kg (SD 4.6 kg) 1 year after surgery and returned to preoperative levels (9.5 kg, SD 5.6 kg) by final follow-up. Wrist pain was significantly reduced from a mean score of 5 (SD 4) preoperatively to 2 (SD 2) postoperatively (p ϭ .01). The Jebsen-Taylor hand function test showed improvements in writing and card turning. Conclusions In the long term, excision of the distal ulna in rheumatoid patients results in an improvement in some aspects of hand function. There is a significant (p ϭ .01) reduction in wrist pain but a reduction of wrist flexion.