In this endresults study the clinical materials used were 147 joints: 103 knees with an average follow up period of 9.6 years,25 elbows with an average follow up about 10 years and 19 ankles with an average follow up about 11 years. They are diagnosed as classical RA. Preoperative findings such as duration of disease, number of major joints involved, age, sex distribution, stage and class of the preoperative patients are not descrived here. However, these patients demonstrated similar data as they reported in the past literature.
Postoperative improvement was investigated concerning the follow ing items which were inflammatory signs such as pain and swelling, R. O. M., degree of patient's satisfaction with surgery, the stage of the joint and the class of the patient. Their findings in the 3 joints were comparcd with the preoperative findings and also compared with each other. It was found that the results were best in the elbow then in the knee and then in the ankle joint.
There is no remarkable difference between these 3 joints concerning postoperative improvement in inflammatory signs.
In all 3 joints excellent reduction in inflammation was achieved. Differences did exist between these 3 joints regarding improvement in postoperative R. O. M.. Postoperative preservation in R.0, M. was best in the elbow, then in the knee and then in the ankle. As to the degree of patient's satisfaction with surgery: Satisfaction was noted in 61% of knee patients,84% of elbow patients,68% of ankle patients. Partial satisfaction was noted in 22% in the knee patients,16% in the elbow patients,16% in the ankle patients. Displeasure with the results was noted in only 17% in the knee joint,0% in the elbow patients,16% in the ankle patients.
The structual damage progressed in every joint postoperatively. But in fact joint s which were in stage 3 preoperatively and then progress to stage 4 were 0% in the elbow,12.5% in the knee,56% in the ankle. The stage of the operated joint remained unchanged in the majority of the elbow and the knee joints. The class of the postoperative patients was fairly well maintained and they did not easily become incapacitated.
It is evident that these “endresults” are more excellent than the results in the survey conducted by multicenters in the U. S. A. as well as in the United kingdom. These findings lead the author to conclude that these innovative s ynovectomies in the elbow, knee and ankle joints have passed the test of time and each of them has now proved to be a trustworthy and useful surgical method in the surgery of rheumatoid arthritis.
