Department of Orthopaedic Surgery, Konan Kakogawa Hospital, Saijo 1545-1, Kanno-cho, Kakogawa 675-8545, Japan.
Mod Rheumatol. 2011 Dec;21(6):598-601. doi: 10.1007/s10165-011-0447-2. Epub 2011 Apr 6.
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.
类风湿关节炎(RA)常累及手指关节,长期慢性滑膜炎不仅可导致骨质破坏,还可导致手指发生各种畸形。当药物和康复等保守治疗对慢性滑膜炎无效时,需进行指间关节滑膜切除术。本研究回顾性分析了 49 个指间关节滑膜切除术治疗 RA 的短期疗效。所有患者分别于术后 2 个时间点(平均随访时间分别为 14 个月和 62 个月)进行评估,并对这 2 个随访时间点的结果进行比较。结果显示,大多数手指的疼痛缓解、肿胀消退,仅轻微活动受限。而且,仅有少数患者出现骨质破坏进展,表明滑膜切除术具有抑制作用,尤其在疾病早期效果更为显著。综上,我们建议在手指出现骨改变之前,以及当手指关节慢性滑膜炎对其他任何保守治疗均无效时,对 RA 患者行指间关节滑膜切除术。