[Value of synovectomy under arthroscopy in the treatment of persistent synovitis in chronic inflammatory rheumatic diseases].

Twelve patients suffering from an inflammatory rheumatic disorder with chronic synovitis of the knee joint were treated by synovectomy using a pneumatic chondrotome under arthroscopic control in combination with abundant articular lavage. All patients had been treated with one or several chemical or radioisotopic synovial instillations followed by failure of treatment or a rapid recurrence of synovitis. Eight patients had a rapid and good or very good therapeutic result with regression of synovitis and of pain during the first month after the synovectomy. This result appears to be maintained more than one year later in the case of the first patients treated. Four patients had a manifest but incomplete improvement. Postoperative follow-up was unremarkable, hospitalization period was short, and no physical rehabilitation was necessary. However, one patient developed stiffness of the knee joint which required its movement under general anesthesia. Arthroscopy with synovectomy and articular lavage appear to offer an interesting therapeutic resolution in case of chronic synovitis unresponsive to medical measures, both locally and systemically administered. Short-term results appear better than those obtained with conventional surgical synovectomy and postoperative follow-up is much simpler.