Arthroscopic synovectomy of the elbow in rheumatoid arthritis

Kiwamu Horiuchi, Shigeki Momohara, Taisuke Tomatsu, Kazuhiko Inoue, Yoshiaki Toyama

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

Background: The purpose of this study was to investigate the results of arthroscopic synovectomy for the treatment of elbows affected by rheumatoid arthritis. Methods: Arthroscopic synovectomy was performed on twenty-nine elbows (twenty-seven patients) between 1984 and 1996. Twenty-one elbows (twenty patients), followed for a minimum of forty-two months, were evaluated clinically with use of the Mayo elbow performance score and radiographic findings. The mean duration of follow-up was ninety-seven months. With use of the system of Larsen et al., we classified all elbows into three groups - Grades 1 and 2, Grade 3, and Grade 4 - according to the preoperative radiographic findings. These groups were then compared. Results: The mean Mayo elbow performance score improved from 48.3 points preoperatively to 77.5 points (an excellent result in two elbows, a good result in thirteen, a fair result in six, and a poor result in none) at two years after the operation and 69.8 points (an excellent result in two elbows, a good result in seven, a fair result in seven, and a poor result in five) at the final follow-up evaluation. The mean score for pain improved from 9.3 points preoperatively to 31.4 points at two years after the operation and 27.9 points at the final follow-up evaluation. Clinically apparent synovitis recurred in five of the twenty-one elbows, and two of the five required total elbow arthroplasty. Among the three groups, only elbows with Larsen Grade-1 or 2 arthritis had a favorable long-term result with regard to total function. The postoperative results were unsatisfactory for Larsen Grade-4 elbows. Conclusions: Arthroscopic synovectomy in an elbow affected by rheumatoid arthritis is a reliable procedure that can alleviate pain. Our results suggest that one of the most favorable indications for arthroscopic synovectomy is a preoperative radiographic rating of Grade 1 or 2.

Original languageEnglish
Pages (from-to)342-347+Adv44
JournalJournal of Bone and Joint Surgery - Series A
Volume84
Issue number3
Publication statusPublished - 2002 Mar 1

ASJC Scopus subject areas

  • Surgery
  • Orthopedics and Sports Medicine

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    Horiuchi, K., Momohara, S., Tomatsu, T., Inoue, K., & Toyama, Y. (2002). Arthroscopic synovectomy of the elbow in rheumatoid arthritis. Journal of Bone and Joint Surgery - Series A, 84(3), 342-347+Adv44.