• Title/Summary/Keyword: Arthroscopic synovectomy

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Arthroscopic Synovectomy of the Knee in Rheumatoid Arthritis (류마토이드 관절염에서 슬관절의 관절경적 활액막 절제술)

  • Chung, Jae-Hoon;Park, Il-Sung;Yang, Dong-Hyun
    • Journal of the Korean Arthroscopy Society
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    • v.1 no.1
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    • pp.91-97
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    • 1997
  • There has been a controversy about the effectiveness of the synovectomy of the knee in the rheumatoid arthritis. So we studied to determine if the arthroscopic synovectomy of the knee was of benefit in the rheumatoid arthritis. We ana lysed 25 knees of 15 patients who underwent the arthroscopic synovectomy of the knee joint for their rheumatoid arthritis from Jun. 1995 to Oct. 1996. The average follow-up period was 20.1 months($12\~28$ months). The results were as follows; 1. Satisfactory results were obtained in 20 knees $(80\%)$ for the pain and the effusion each, 23 $(92\%)$ for the range of motion and 19 $(76\%)$ for the functional capacity. 2. In the overall results for the pain. effusion. range of motion and the functional capacity. we obtained excellent results in 14 knees $(56\%)$ and satisfactory results in 9 knees $(32\%)$. 3. In the patient's self assessment, 11 patients $(44\%)$ were delighted and 10 patients $(40\%)$ were satisfactory. 4. In the overall results according to the articular cartilage damage, satisfactory results were obtained in 15 $(93\%)$ out of 16 knees in Grade I and II, and 6 $(75\%)$ out of 8 knees in Grade III and IV. In conclusion, arthroscopic synovectomy could be one of very useful treatments for the rheumatoid knee. But further study is needed to get the long-term results of the synovectomy because there's many reports saying gradual decrease of good results with increasing time. And continuous and proper medical treatment including DMARDs, is needed to effectively control the rheumatoid arthritis even after the synovectomy.

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Surgical Treatment for Diffuse Pigmented Villonodular Synovitis of the Ankle by A Combined Open and Arthroscopic Synovectomy: A Case Report (발목관절의 미만형 색소 융모 결절성 활액막염에서 관절경적 및 개방적 활액막 절제술을 이용한 수술적 치료: 증례 보고)

  • Choi, Jun-Cheol;Song, Woo-Suk;Byun, Chan-Woong;Kim, Jin;Han, Eun-Mee
    • Journal of Korean Foot and Ankle Society
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    • v.23 no.3
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    • pp.139-142
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    • 2019
  • Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving the synovial membranes. Complete excision with a total synovectomy is important for diffuse type PVNS because of its high recurrence rate. In the ankle, complete excision of diffuse type PVNS is difficult due to the anatomical structure of the ankle joint. This paper reports the author's experience of surgical treatment with combined open and arthroscopic synovectomy. In this manner, it is expected that the complications of the open procedure and the recurrence rate of arthroscopic procedure can be reduced.

Arthroscopic Treatment of Synovial Chondromatosis (활액막 연골종증의 관절경적 치료)

  • Bae Dae Kyung;Kwon Oh Soo;Lee Jeong Heui;Lim Chan Teak
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.1
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    • pp.43-48
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    • 2002
  • Purpose : We evaluated the results of the arthroscopic treatment of nine cases of synovial chondromatosis in the knee joints. Materials and Methods : From June 1989 to September 1999, eight patients nine cases with synovial chondromatosis involving knee joints underwent arthroscopic total synovectomy and removal of loose bodies. There were 6 females and 2 males. The average age at surgery was 44.1 years(range, 20-57 years). The average follow-up period was 5.9 years (range, 2.5-7.3 years). All cases had pain and swelling and two cases had locking preoperatively. Flexion contracture was found in three cases. Results : Pathologic finding revealed Milgram I in one case, Milgram II in six cases and Milgram III in two cases. There were six cases of generalized synovial hypertrophy and one case of localized type. All patients had symptomatic relief by arthroscopic total synovectomy and loose body removal. Second arthoroscopic surgery was performed in one patient due to recurred lesions 11 months after the primary surgery. Conclusion : Clinical results of the synovial chondromatosis with arthroscopic total synovectomy and loose body removal were satisfactory. Arthroscopic total synovectomy was also effective for the recurred case.

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Arthroscopic Synovectomy of the Knee in Hemophilic Patients (혈우병성 슬관절염의 관절경적 활액막 제거술)

  • Bae, Dae-Kyung;Yoon, Kyoung-Ho;Kim, Hee-Seon;Kim, Seung-Hwan;Chung, Sun-Teak
    • Journal of the Korean Arthroscopy Society
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    • v.6 no.2
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    • pp.177-182
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    • 2002
  • Purpose : To validate the arthroscopic synovectomy for the treatment of hemophilic knee. Materials and Methods: From January 1996 to January 2001, 28 arthroscopic synovectolny were performed in 26 patients with hemophilic arthropathy of the knee. The mean age was 17.8 years. The mean follow-up period was 3 years 11 months. We used six portals (two anterior, two suprapatellar and two posterior) and posterior trans-septal portal in all cases. Result : The mean frequency of hemarthrosis was 4 times per month preoperatively and 2 postoperatively. The mean amount of factor replacement was 4,633 units preoperatively and 1,505 postoperatively. The mean range of motion was $112^{\circ}$ preoperatively and $107^{\circ}$ postoperatively. On radiographic evaluation, three cases were progressed at the latest follow-up. On the subjective evaluation, significant or moderate improvement were in 19 cases $(68\%)$, and no improvement or deterioration in 9 cases $(32\%)$. Conclusion : With complete synovectomy through the appropriate arthroscopic portals, arthroscopic synovectomy of the knee in hemophilic patients is the successful method in decreasing bleeding episodes, amount of factor replacement, knee pain and preventing or delaying onset of end-stage hemophilic arthropathy.

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Arthroscopic Treatment for the Pigmented Villonodular Synovitis in the Knee (관절경을 이용한 슬관절의 색소 응모 결절성 활액막염의 치료)

  • Kim, Kyung-Taek;Kim, Chul-Hong;Lee, Myung-Jin
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.2
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    • pp.111-115
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    • 2001
  • Purpose : To confirm the efficacy of arthroscopic synovectomy for the pigmented villonodular synovitis in the knee. Materials and Methods : We analysed 8 patient(9 cases) that were diagnosed and performed arthroscopic synovectomy as pigmented villonodular synovitis from July 1992 to May 2000. The diagnosis was confirmed by pathologist. The average follow-up period was 29 months(range, $15\~48$ months). The average age at initial visit was 40.4 years(rage, $15\~67$ years). Male were 6 cases and female 2 cases. The average duration from onset of the symptom to the operation was 23 months($2\~86$ months). Previous history of the trauma was noted in 2 case. There was 1 case involved both knee joints. Results : According to the athroscopic findings, there were 4 localized forms and 5 diffuse forms. At preoperational examinations, the average of flexion contracture was $4.4^{\circ}(0\~5^{\circ})$ and that of the further flexion was $117.8^{\circ}(90\~135^{\circ})$. At last follow-up examinations, the knee range of motion was normalized, the average of flexion range was $133.9^{\circ}(120\~140^{\circ})$. All patients had improvement in pain, swelling and range of motion and there was no evidence of recurrence. Conclusion : In the pigmented villonodular synovitis, arthroscopic synovectomy can be considered one of the good modality to expect good results.

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Diffuse Pigmented Villonodular Synovitis of the Knee: Case Report (무릎 관절의 미만형 색소 융모 활액막염: 증례 보고)

  • Choi, Sang-Gyu
    • Radiation Oncology Journal
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    • v.25 no.4
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    • pp.278-282
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    • 2007
  • Purpose: Diffuse pigmented villonodular synovitis (PVNS) is an uncommon aggressive synovial proliferative disorder of unknown etiology affecting the joint linings. Though a histologically benign inflammatory process, because of its aggressive growth with bone destruction or recurrence, it is frequently suggested to occur as a low malignant neoplasm. Optimal treatment is surgery, but the local recurrence rate after radical synovectomy for diffuse PVNS is relatively high due to the infiltrative growth pattern. External beam radiotherapy with moderate doses or intra-articular instillation of radioactive isotopes may improve the likelihood of local control and long-term function in patients with incompletely resected or recurrent diffuse PVNS. I report one case of diffuse PVNS of the right knee joint treated with arthroscopic synovectomy and external beam radiotherapy is presented.

Arthroscopic Synovectomy of the Shoulder Joint for Rheumatoid Arthritis (류마티스 관절염환자에서 견관절의 관절경적 활액막절제술)

  • Kim, Kyung-Taek;Lee, Myung-Jin;Kim, Wook
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.76-80
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    • 2003
  • Purpose : To analyze the result of arthroscopic synovectomy of the shoulder for rheumatoid arthritis. Material and Method : Sixteen patients were treated from May, 1998 to December, 2002 who undergone arthroscopic synocvectomy of the shoulder for rheumatoid arthritis. The study group constisted 2 men and 14 women. the age at surgery ranged from 32 to 66 years, with average of 50 years. The result were analyzed using the clinical assessment of shoulder surgery classification system issued by the Japanese Orthopaedic Association and subjective satisfactation of the patients cartegorized excellent, good, poor. Results : The mean score of ROM was increased from 13.9 preoperative to 23.8 postoperative and the mean score of pain was inclosed from 22.0 preoperative to 26.5 postoperative. The result of subjective satisfaction were 7 excellent, 7 good,2 unsatisfied, so forteen cases $(88\%)$ above the good. Conclusions : The shorter morbidity date, and the letter damage of articular cartillage, the better results of the arthroscopic synocvectomy of the shoulder for rheumatoid arthritis.

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Arthroscopic Treatment for the Pigmented Villonodular Synovitis in the Knee (슬관절에 발생한 색소 융모 결절성 활액막염의 관절경적 치료)

  • Bae, Dae-Kyung;Cho, Nam-Su
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.22-26
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    • 2001
  • Purpose : To confirm the efficacy of arthroscopic synovectomy fur the pigmented villonodular synovitis in the knee. Materials and Methods : Between October 1996 and February 2000, the arthroscopic synovectomy had been performed in six patients(six knee joints), whose diagnoses were confirmed by pathologist. All patients complained of painful swelling in involved knee and four of the six patients had trauma history. There were three male and three female patients. Average age was 35.8 years ranging from 16 to 67 years. Follow up period was average 22.7 months(range, $13\~53$ months). Results : According to arthroscopic findings, there were three localized forms and three diffuse forms. At their last follow-up examinations, all patients had improvement in pain, swelling and range of motion and there was no evidence of recurrence. Conclusion : Complete arthroscopic excision is the definitive treatment for localized pigmented villonodular synovitis and meticulous arthroscopic excision through all portals including posterior portal can be considered as a valid alternative to traditional open synovectomy for the patients with diffuse pigmented villonodular synovitis.

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