Long-term results of open elbow synovectomy for rheumatoid arthritis

Nakagawa, Natsuko; Abe, Shuji; Saegusa, Yasuhiro; Imura, Satoru; Kubo, Hitoshi; Nishibayashi, Yasuro; Yoshiya, Shinichi

doi:10.1007/s10165-006-0547-6

Cited by 6 publications

(1 citation statement)

References 14 publications

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“…The efficacy of synovectomy for joints at radiographically early stages and TEA for joints at radiographically advanced stages has been confirmed repeatedly (Brumfield and Resnick 1985, Stein et al 1975, Saito 1986, Ferlic et al 1987, Figgie et al 1989, Tulp and Winia 1989, Koshino 1991, Gendi et al 1997, Connor and Morrey 1998, Fuerst et al 2006, Nakagawa et al 2007). Our cases underwent open elbow synovectomy, but several reports suggest the efficacy of arthroscopic synovectomy for rheumatoid elbow at radiographically early stages (Lee and Morrey 1997, Horiuchi et al 2002, Tanaka et al 2006).…”

Section: Discussionmentioning

confidence: 90%

Good long-term outcome of synovectomy in advanced stages of the rheumatoid elbow

et al. 2012

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Background and purpose Synovectomy is an effective procedure for management of the rheumatoid elbow at radiographically early stages (Larsen grades 1 and 2). However, its efficacy for advanced stages (Larsen grades 3–5) is controversial. We investigated the outcome of synovectomy for advanced stages of the rheumatoid elbow.Methods Between May 1985 and September 1994, synovectomy was performed for 67 rheumatoid elbows in 59 patients (mean age 52 (26–72) years, 54 women). 3 elbows (3 patients) were lost to follow-up after mean 15 (10–23) years. Thus, 64 elbows were evaluated clinically and radiographically.Results The mean Mayo elbow performance score (MEPS) improved from 42 (15–75) points preoperatively to 78 (45–100) points at the final follow-up examination. In cases of Larsen grade 5, the mean MEPS at final follow-up examination (69 points) was lower than those of Larsen grade 3 and 4 cases (80 and 79 points, respectively) (p < 0.01). Recurrence of synovitis was obvious in 20/67 elbows. 12 cases had a total elbow arthroplasty mean 13 years after the synovectomy. The 10-year, 15-year, and 20-year survival rates were 97%, 75%, and 70%, respectively.Interpretation Our findings suggest that synovectomy for the rheumatoid elbow gives a good long-term outcome for radiographically judged destroyed joints of Larsen grades 3–4.

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Section: Discussionmentioning

confidence: 90%

Good long-term outcome of synovectomy in advanced stages of the rheumatoid elbow

et al. 2012

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Postoperative results and complications of total elbow arthroplasty in patients with rheumatoid arthritis: three types of nonconstrained arthroplasty

et al. 2008

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Postoperative results and complications of total elbow arthroplasty (TEA) conducted for rheumatoid arthritis (RA) patients at our institute were studied. Primary TEAs were performed in 72 patients. The mean follow-up period was 3.5 years. Three types of prostheses were implanted: JACE prosthesis in 34 elbows, STABLE prosthesis in 13 elbows, and KUDO prosthesis (type 5) in 32 elbows. The outcome was evaluated by the change in the range of motion and the Japanese Orthopaedic Association functional evaluation score for the elbow joint (JOA score). The arc of motion and the JOA score at discharge and at final examination significantly improved in patients with the three types of prosthesis. The loosening rates for the JACE, STABLE and KUDO prostheses were 15, 23, and 0%, respectively, although the follow-up periods were different. The loosening rate decreased to 2.5% when the humeral component was fixed with cement. Intraoperative fractures occurred in eight (10.1%) elbows and ulnar nerve palsy in six. Deep infection developed in three (4.8%) elbows and was treated by removing the prosthesis. Although there were considerable complications, the marked improvements in pain and function favor TEA in patients with rheumatoid elbow.

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Short-term outcome of finger joint synovectomy in rheumatoid arthritis

et al. 2011

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Rheumatoid arthritis (RA) frequently affects finger joints, and persistent synovitis is believed to cause not only bone destruction but also various deformities of the fingers in the long run. Synovectomy of the finger joints is carried out when chronic swelling of the synovium does not respond to any conservative treatment with medication and rehabilitation. In the present study the short-term results of finger joint synovectomy in RA were reviewed in 49 finger joints. The subjects were evaluated at two time points, with average follow-up periods of 14 and 62 months, and the results were compared between the two follow-up time points. In regard to results, pain relief, swelling abatement, and only a little loss of motion were observed in most fingers. Moreover, only a few patients demonstrated progression of bone destruction, suggesting that synovectomy has a retarding effect and tends to be effective especially in the early stages of the disease. In conclusion, we recommend synovectomy for finger joints in RA patients before bone changes occur, and when chronic synovitis of the finger joints does not respond to any other conservative treatment.

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Long-term results of open elbow synovectomy for rheumatoid arthritis

Cited by 6 publications

References 14 publications

Good long-term outcome of synovectomy in advanced stages of the rheumatoid elbow

Good long-term outcome of synovectomy in advanced stages of the rheumatoid elbow

Postoperative results and complications of total elbow arthroplasty in patients with rheumatoid arthritis: three types of nonconstrained arthroplasty

Short-term outcome of finger joint synovectomy in rheumatoid arthritis

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