Arthroscopic synovectomy of the ankle in rheumatoid arthritis

Woo Jin Choi, Gi Won Choi, Jin Woo Lee

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Purpose: To evaluate the outcome of arthroscopic synovectomy of the ankle joint in patients with early-stage rheumatoid arthritis (RA). Methods: Between 2005 and 2009, 18 consecutive patients with RA involving the ankle underwent arthroscopic synovectomy. Pain was measured using a visual analog scale (VAS), and clinical outcome was determined by calculating the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale score with a mean follow-up of 5 years (60 months). Assessments were performed preoperatively, at 6 and 12 months postoperatively, and then yearly thereafter. Clinical success was defined as the absence of synovitis symptoms or when patients demonstrated good or excellent outcomes (AOFAS Ankle-Hindfoot Scale score ≥80) with >50% improvement in VAS score for pain. Demographic, laboratory, and radiological variables were evaluated to determine possible factors predicting clinical outcome. Results: VAS and AOFAS scores were significantly improved at the final follow-up (60 months; P <.0001). The greatest improvements in clinical scores were observed after 12 months; thereafter, they steadily declined. Of the 18 patients examined, 14 (77.8%) were considered to have had clinical success with no reintervention. Variables predictive of clinical success were short duration of symptoms (P =.042) and minimal radiographic changes based on the Larsen grading system (P =.030). Conclusions: Arthroscopic synovectomy is a safe and successful procedure in ankle joints affected by RA. The best clinical outcomes are achieved when the procedure is performed early in the disease course and when there is no evidence of cartilage degeneration. Level of Evidence: Level IV, prognostic case series.

Original languageEnglish
Pages (from-to)133-140
Number of pages8
JournalArthroscopy - Journal of Arthroscopic and Related Surgery
Volume29
Issue number1
DOIs
Publication statusPublished - 2013 Jan 1

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Ankle
Rheumatoid Arthritis
Orthopedics
Foot
Ankle Joint
Visual Analog Scale
Synovitis
Pain Measurement
Cartilage
Demography
Pain

All Science Journal Classification (ASJC) codes

  • Orthopedics and Sports Medicine

Cite this

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title = "Arthroscopic synovectomy of the ankle in rheumatoid arthritis",
abstract = "Purpose: To evaluate the outcome of arthroscopic synovectomy of the ankle joint in patients with early-stage rheumatoid arthritis (RA). Methods: Between 2005 and 2009, 18 consecutive patients with RA involving the ankle underwent arthroscopic synovectomy. Pain was measured using a visual analog scale (VAS), and clinical outcome was determined by calculating the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale score with a mean follow-up of 5 years (60 months). Assessments were performed preoperatively, at 6 and 12 months postoperatively, and then yearly thereafter. Clinical success was defined as the absence of synovitis symptoms or when patients demonstrated good or excellent outcomes (AOFAS Ankle-Hindfoot Scale score ≥80) with >50{\%} improvement in VAS score for pain. Demographic, laboratory, and radiological variables were evaluated to determine possible factors predicting clinical outcome. Results: VAS and AOFAS scores were significantly improved at the final follow-up (60 months; P <.0001). The greatest improvements in clinical scores were observed after 12 months; thereafter, they steadily declined. Of the 18 patients examined, 14 (77.8{\%}) were considered to have had clinical success with no reintervention. Variables predictive of clinical success were short duration of symptoms (P =.042) and minimal radiographic changes based on the Larsen grading system (P =.030). Conclusions: Arthroscopic synovectomy is a safe and successful procedure in ankle joints affected by RA. The best clinical outcomes are achieved when the procedure is performed early in the disease course and when there is no evidence of cartilage degeneration. Level of Evidence: Level IV, prognostic case series.",
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Arthroscopic synovectomy of the ankle in rheumatoid arthritis. / Choi, Woo Jin; Choi, Gi Won; Lee, Jin Woo.

In: Arthroscopy - Journal of Arthroscopic and Related Surgery, Vol. 29, No. 1, 01.01.2013, p. 133-140.

Research output: Contribution to journalArticle

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AB - Purpose: To evaluate the outcome of arthroscopic synovectomy of the ankle joint in patients with early-stage rheumatoid arthritis (RA). Methods: Between 2005 and 2009, 18 consecutive patients with RA involving the ankle underwent arthroscopic synovectomy. Pain was measured using a visual analog scale (VAS), and clinical outcome was determined by calculating the American Orthopaedic Foot and Ankle Society (AOFAS) Ankle-Hindfoot Scale score with a mean follow-up of 5 years (60 months). Assessments were performed preoperatively, at 6 and 12 months postoperatively, and then yearly thereafter. Clinical success was defined as the absence of synovitis symptoms or when patients demonstrated good or excellent outcomes (AOFAS Ankle-Hindfoot Scale score ≥80) with >50% improvement in VAS score for pain. Demographic, laboratory, and radiological variables were evaluated to determine possible factors predicting clinical outcome. Results: VAS and AOFAS scores were significantly improved at the final follow-up (60 months; P <.0001). The greatest improvements in clinical scores were observed after 12 months; thereafter, they steadily declined. Of the 18 patients examined, 14 (77.8%) were considered to have had clinical success with no reintervention. Variables predictive of clinical success were short duration of symptoms (P =.042) and minimal radiographic changes based on the Larsen grading system (P =.030). Conclusions: Arthroscopic synovectomy is a safe and successful procedure in ankle joints affected by RA. The best clinical outcomes are achieved when the procedure is performed early in the disease course and when there is no evidence of cartilage degeneration. Level of Evidence: Level IV, prognostic case series.

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