Paus A C, Dale K
Department of Orthopaedic Surgery and Radiology, Oslo Sanitetsforening Rheumatism Hospital, Norway.
Ann Chir Gynaecol. 1993;82(1):55-61.
In a 5-year follow-up after open knee joint synovectomy in 18 patients with juvenile rheumatoid arthritis (JRA) there was no radiographic progression of the juvenile rheumatoid arthritic changes. Radiographic evidence indicative of osteoarthrosis and of the soft tissue swelling were scored separately. Radiographic changes consistent with osteoarthrosis increased significantly during the observation period (P < 0.001). Arthroscopic evaluation of cartilage changes and radiographic evaluation of osteoarthrosis correlated significantly (P = 0.004). These were the only parameters found predicting the development of further cartilage destruction (P = 0.001). Clinically, the patients had significant improvement five years following synovectomy (P = 0.018), even though three patients required resynovectomy (one successfully after four years, and two patients are waiting for resynovectomy). At the 5-year follow-up both radiographic and clinical data indicate that juvenile rheumatoid arthritic activity of the knee joint was reduced following open synovectomy while osteoarthrosis developed. A new system of scoring radiographic JRA changes of the knee joint was found useful.
对18例青少年类风湿性关节炎（JRA）患者行开放性膝关节滑膜切除术后进行了5年随访，结果显示青少年类风湿性关节炎的改变并无影像学进展。分别对提示骨关节炎和软组织肿胀的影像学证据进行评分。在观察期内，与骨关节炎相符的影像学改变显著增加（P<0.001）。关节镜下软骨改变评估与骨关节炎的影像学评估显著相关（P = 0.004）。这些是仅有的被发现可预测进一步软骨破坏发展的参数（P = 0.001）。临床上，患者在滑膜切除术后5年有显著改善（P = 0.018），尽管有3例患者需要再次行滑膜切除术（1例在4年后成功，2例患者正在等待再次滑膜切除术）。在5年随访时，影像学和临床数据均表明，开放性滑膜切除术后膝关节的青少年类风湿性关节炎活动度降低，同时出现了骨关节炎。一种新的膝关节类风湿性关节炎影像学改变评分系统被证明是有用的。
