A prospective randomized trial of total synovectomy versus limited synovectomy in primary total knee arthroplasty: evaluation of bleeding, postoperative pain, and quality of life with SF-12 v2

Abstract

Performing a TS in TKA in patients with osteoarthrosis does not result in a relevant lower postoperative pain, or in an improvement in HRQOL, and it does increase the amount of bleeding after the procedure.

Adult Measures of General Health and Health‐Related Quality of Life

“…The SF‐12 has been used as an outcome measure in clinical trials to evaluate the efficacy of a broad range of interventions for rheumatic conditions, including pharmacological treatment for osteoarthritis of the hip, knee, and hand ; hydrotherapy treatment for osteoarthritis and fibromyalgia ; Tai Chi for hip or knee osteoarthritis ; hand exercises for rheumatoid arthritis ; foot orthoses for rheumatoid arthritis ; self‐management for fibromyalgia ; surgical procedures, eg, total hip arthroplasty and total knee arthroplasty ; and postsurgical rehabilitation (exercise following total knee arthroplasty) .…”

Should synovectomy be performed in primary total knee arthroplasty for osteoarthritis? A meta-analysis of randomized controlled trials

“…Three studies [16, 17, 19], including 435 knees, evaluated postoperative pain. Statistical heterogeneity was found in VAS ( I 2 = 95%, P < 0.00001), and a random effects model was applied.…”

“…Two studies [15, 16], involving 188 knees, reported complications. A fixed effects model was utilized ( I 2 = 9%, P = 0.30).…”

“…Synovectomy has advantageous effects, but also adverse effects. Bernal-Fortich et al [16] report that synovectomy increases the amount of bleeding after the procedure, with a difference of 9 g/l of pre- and postoperative hemoglobin. Tanavalee et al [18] conclude that synovectomy in TKA does not shorten the duration of the inflammatory response after surgery.…”

“…Kilicarslan et al [19] found that the VAS score at 3 months was lower in the synovium-retaining group. Bernal-Fortich et al [16] reported that postoperative pain was significantly lower in the synovectomy group at 24 h and 48 h ( P < 0.001). However, the difference was statistically significant; it was not clinically relevant.…”