Abstract
To analyze functional outcome of arthroscopic synovectomy in effect attenuation cases of biologics for rheumatoid arthritis (RA), we investigated 17 cases, 30 joints, 3 male and14female, mean age of 54.8 (40-71) years old, mean disease duration of 9.9 (1-36), mean follow-up periods of 36.7 (12-60) months, mean MTX of 6.2 (4-8) mg/weeks, mean prednisolone of 4.3 (0-7.5) mg/day including 17 knee joints, 7 shoulder joints, 3 elbow joints and 3 wrist joints for arthroscopic synovectomy. We compared DAS28 (CRP) and HAQ before and after surgery, especially compared between knee joints synovectomy and shoulder or elbow joints synovectomy. We found DAS28 significant improvement from 5.17±0.56 to 3.14±0.44 and HAQ significant improvement 1.53±0.79 to 0.58±0.53 after 3 years. HAQ remission (＜0.05) was 47%. In shoulder and elbow arthroscopic synovectomy, standing and extension of HAQ improved significantly. On the other hand, in knee arthroscopic synovectomy, almost all items of HAQ improved significantly. The correlations between before and 3 years after arthroscopic synovectomy were recognized significantly. Therefore combination therapy of biologics and arthroscopic synovectomy is useful to improve function of RA patients.
