抄録
Objective: Arthroscopic synovectomy of the hip in patients with rheumatoid arthritis (RA) has not been reported. We investigated whether arthroscopic synovectomy is effective for rheumatoid hip by evaluating six patients followed for longer than 4 years after surgery.
Methods: Six patients who fulfilled the American Rheumatism Association (ACR) diagnostic criteria for RA were included in the present study. All patients were categorized according to Larsen. All patients were women with a mean age at operation of 57 (range 39-75) years and a mean follow-up period of 4.1 (range 4-4.5) years. The Larsen grade, disease activity, JOA score, and other treatments were examined.
Results: Before the operation, one patient was categorized as Larsen grade 1, one as grade 3, and four as grade 4. At the final evaluation, one patient was categorized as Larsen grade 3 and the others as grade 4. We observed a temporary improvement of serum C-reactive protein levels in all patients; however, 6 months after the operation, these had returned to preoperative levels. The mean JOA score improved from 45.3 to 56.5. All patients received preoperative treatment with disease-modifying antirheumatic drugs (DMARDs) and had a history of steroid use. Four patients used biologics during the postoperative follow-up period.
Conclusion: Arthroscopic synovectomy of the hip was useful for ameliorating joint pain but was not useful for managing structural damage. Four of the six patients managed to avoid total hip arthroplasty in the medium term.
