We suggest that during TKA, the use of tourniquet induces local release of a large amount of NE from neutrophils, inducing the development of DVT and/or PTE and their exacerbation.

Our results show that the effects of a combination of DEX with any two of BUC, GST, SASP and MTX on the production of VEGF and bFGF in cultured synoviocytes and on the serum concentrations of VEGF in patients with RA may be based on synergistic or additive effects of the drugs.

These results suggest that the use of a tourniquet will promote the risk of developing postoperative PE and/or DVT after total knee arthroplasty.

No abstract

We assessed the anti-rheumatic effects of radical multiple synovectomy (RaMS) in patients with rheumatoid arthritis (RA) who did not respond to intensive medical treatment. The selection of patients into three groups, A, B or C, was randomised. Patients assigned to group A (n=28) continued the prescribed pre-operative medication and had RaMS. Patients assigned to group B (n=20) were started on a combination therapy with disease-modifying anti-rheumatic drugs (DMARDs) after radical multiple synovectomy. Nineteen RA patients who were started on the same combination therapy as group B but who did not undergo surgery served as controls (group C). The clinical and radiographic findings were assessed for at least 3 years after surgery. Patients in the surgically treated groups (groups A and B) showed a significant reduction in the number of swollen and painful joints and in their ESR and serum CRP levels, and this effect was maintained for at least 3 years. More than 40% of the patients remained in clinical remission during the observation period. The surgical outcome seemed to be superior to that of the controls and did not differ between group A and group B. Articular destruction (assessed by the carpal height ratio) did not progress in the patients who were in clinical remission.Résumé Nous avons étudié les effets anti-rhumatoïde de la synovectomie complète multiple dans trois groupes de patients atteints d'arthrite rhumatoïde réfractaire au traitement médical. La sélection des patients en trois groupes a été faite au hasard. Les patients du groupe A (n=28) ont continué le traitement pré-opératoire prescrit; ceux du groupe B (n=20) ont commencé, après l'intervention un traitement par médicaments anti-rhumatismaux. Enfin 19 patients qui ont commencé la même combinaison thérapeutique que le groupe B mais sans intervention chirurgicale ont servi de groupe de contrôle. Les patients ont été suivis au moins 3 ans après le traitement chirurgical. Les patients traités par synovectomie ont montré une réduction du nombre d'épanchement, de douleurs articulaires ainsi qu'une diminution de la vitesse de sédimentation et du niveau de la CRP ceci s'étant maintenu pour au moins 3 ans. Plus de 40% des patients sont restés en rémission clinique durant la période d'observation. Les destructions articulaires mesurées par la hauteur du carpe n'ont pas progressé pendant la période de rémission.