Masłoń Adrian, Witoński Dariusz, Pieszyński Ireneusz, Grzegorzewski Andrzej, Synder Marek
Department of Orthopaedics and Paediatric Orthopaedics, Medical University, Łodz.
Ortop Traumatol Rehabil. 2007 Sep-Oct;9(5):520-6.
The authors compared early results of open and arthroscopic knee joint synovectomy in patients with nonspecific exudative synovitis and rheumatoid arthritis.
The study comprised two groups of patients matched for age, preoperative range of motion in the involved knee and etiology of synovitis. Group I included patients after open synovectomy and group II consisted of subjects following an arthroscopic procedure. Blood loss, analgesic intake, duration of hospitalization, range of flexion and extension in the involved knee at discharge as well as 3 and 6 months following surgery were compared, together with respective recurrence rates.
A statistically significant decrease in blood loss and a shorter duration of hospitalization were found in group II compared to group I; no differences were observed in postoperative analgesic use. Mean flexion range was significantly greater before surgery than in the 3 analyzed time intervals in both study groups except for knee flexion in group II compared before and 6 months following the intervention. However, mean flexion range in the operated joint at discharge and 3 months postoperatively was significantly greater in group II as compared with group I. A comparison of the knee extension range between the groups revealed significantly higher values in group II at discharge, but no statistically significant differences were found in the subsequent follow-up assessments. However, flexion contractures developed 6 months after surgery in 5 patients from group I and in 1 patient from group II. No recurrence of effusion was observed in either group.
According to the authors, arthroscopic synovectomy reduces blood loss following surgery, shortens duration of hospitalization and permits faster recovery.
作者比较了开放性和关节镜下膝关节滑膜切除术治疗非特异性渗出性滑膜炎和类风湿性关节炎患者的早期结果。
该研究包括两组年龄、患侧膝关节术前活动范围及滑膜炎病因相匹配的患者。第一组包括接受开放性滑膜切除术的患者，第二组由接受关节镜手术的患者组成。比较两组患者的失血量、镇痛药摄入量、住院时间、出院时以及术后3个月和6个月患侧膝关节的屈伸范围，以及各自的复发率。
与第一组相比，第二组患者的失血量有统计学意义的减少，住院时间缩短；术后镇痛药使用情况无差异。除第二组干预前与干预后6个月的膝关节屈曲外，两个研究组术前的平均屈曲范围均显著大于3个分析时间点的屈曲范围。然而，与第一组相比，第二组患者出院时及术后3个月手术关节的平均屈曲范围显著更大。两组膝关节伸展范围比较显示，第二组出院时伸展范围显著更高，但在随后的随访评估中未发现统计学显著差异。然而，第一组有5例患者和第二组有1例患者在术后6个月出现屈曲挛缩。两组均未观察到积液复发。
作者认为，关节镜下滑膜切除术可减少术后失血量，缩短住院时间，并能更快恢复。
