Department of Orthopedic Surgery, Yeungnam University College of Medicine, 170 Hyeonchung-ro Nam-gu, Daegu, 42415, Republic of Korea.
Department of Orthopedic Surgery, Yeungnam University Medical Center, 170 Hyeonchung-ro Nam-gu, Daegu, 42415, Republic of Korea.
J Orthop Surg Res. 2022 Mar 3;17(1):132. doi: 10.1186/s13018-022-03024-5.
This article introduces a novel open synovectomy technique using an arthroscopy shaver blade to effectively remove intra-articular synovitis during revision surgery for infected primary total knee arthroplasty.
METHODS (TECHNIQUES): Open synovectomy is performed using a 4.2-mm arthroscopy shaver blade, and the handpiece is connected to suction drainage. Suction is supplied through the central cylinder of the shaver blade to bring the debrided fragments of soft tissue into the window. Grossly inflamed, reddened, diseased synovium is debrided to reveal yellowish, healthy synovium. The inflamed tissues of the knee joint (suprapatellar pouch, medial and lateral gutters, and peripatellar area) are debrided. Then, with maintaining full flexion of the knee joint, a shaver equipped with a longer bar can be used to easily access the medial and lateral posterior compartments, which are generally difficult to access.
During a mean of 13.5-month follow-up, there was no recurrent infection in either group; however, patients who underwent the novel technique improved significantly faster in terms of acute serological markers during the first period.
This technique yielded favorable outcomes compared with the conventional technique. In particular, it may facilitate the approach to the posterior joint space, which is difficult to access.
本文介绍了一种新的开放式滑膜切除术技术，使用关节镜刨削刀片，可在感染性初次全膝关节置换翻修手术中有效清除关节内滑膜炎。
方法（技术）：开放式滑膜切除术采用 4.2mm 关节镜刨削刀片进行，将手持件连接到抽吸引流。通过刨削刀片的中心管提供抽吸，将切除的软组织碎片带入窗口。切除明显红肿、病变的滑膜，露出黄色、健康的滑膜。切除膝关节的炎症组织（髌上囊、内外侧隐窝和髌周区域）。然后，在保持膝关节完全弯曲的情况下，使用配备更长杆的刨削器可轻松进入通常难以触及的内侧和外侧后间室。
在平均 13.5 个月的随访中，两组均无复发性感染；然而，采用新技术的患者在前一阶段急性血清学标志物方面的恢复速度明显更快。
与传统技术相比，该技术的效果更优。特别是，它可能更容易进入难以触及的关节后空间。
