Abstract

Background:

Synovectomy has been introduced into total knee arthroplasty (TKA) with the aim of relieving pain and inflammation of the synovium. However, there are no long-term, comparative data to evaluate the effect of synovectomy in TKA. This study was aimed at assessing pain, function, and complications in patients undergoing synovectomy during TKA for osteoarthritis (OA) at long-term follow-up.

Methods:

This was a prospective randomized controlled trial of 42 consecutive patients who underwent staged bilateral TKA. Patients undergoing the first-side TKA were allocated to receive TKA with or without synovectomy followed by a 3-month washout period and crossover to the other strategy for the opposite-side TKA. The overall efficacy of both strategies was evaluated by determination of blood loss, the Knee Society score (KSS), and knee inflammation conditions during a 3-month postoperative period. The postoperative pain, range of motion (ROM), and complications were sequentially evaluated to compare the two groups until 10 years after surgery.

Results:

At the 10-year follow-up, both groups had a similarly significantly improved ROM (114.88 ± 9.84° vs. 114.02 ± 9.43°, t = 0.221, P = 0.815) and pain relief with no differences between the two groups (1.0 [1.0] vs. 1.0 [1.5], U = 789.500, P = 0.613). Similar changes in total blood loss, KSS, and knee inflammation were found in both groups during 3 months postoperatively (P > 0.05). Additionally, there was no significant difference regarding complications and satisfaction between the two groups (P > 0.05).

Conclusions:

Synovectomy in conjunction with TKA for primary OA does not seem to provide any benefit regarding postoperative pain, ROM, and satisfaction during a 10-year follow-up. In addition, it may not result in more blood loss and increased incidence of long-term complications. Based on our long-term findings, it should not be performed routinely.

Trial registration:

Chinese Clinical Trial Registry, ChiCTR-INR-16008245; https://www.chictr.org.cn/showproj.aspx?proj=13334.

Details

Title
Long-term results of synovectomy in total knee arthroplasty: a prospective, randomized controlled trial
Author
Zeng Weinan 1 ; Yu Zeping 1 ; Wang, Simeng 2 ; Chen Anjing 1 ; Zeng Yiping 3 ; Yang, Qingjun 3 ; Li, Yujuan 1 ; Li, Qi 1 ; Zhou Zongke 1 

 Department of Orthopedics, Orthopedic Research Institute, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China 
 Department of Orthopedics, Chongqing General Hospital, University of Chinese Academy of Sciences, Chongqing 400014, China 
 Department of Radiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, China 
Pages
73-81
Section
Original Articles
Publication year
2023
Publication date
Jan 2023
Publisher
Lippincott Williams & Wilkins Ovid Technologies
ISSN
03666999
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
2783361718
Copyright
Copyright © 2023 The Chinese Medical Association, produced by Wolters Kluwer, Inc. under the CC-BY-NC-ND license. This work is published under http://creativecommons.org/licenses/by-nc-nd/4.0 (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.