Long-term results of synovectomy in total knee arthroplasty:a prospective,randomized controlled trial  

作　　者：Weinan Zeng Zeping Yu Simeng Wang Anjing Chen Yiping Zeng Qingjun Yang Yujuan Li Qi Li Zongke Zhou 

机构地区：[1]Department of Orthopedics,Orthopedic Research Institute,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China [2]Department of Orthopedics,Chongqing General Hospital,University of Chinese Academy of Sciences,Chongqing 400014,China [3]Department of Radiology,West China Hospital,Sichuan University,Chengdu,Sichuan 610041,China

出　　处：《Chinese Medical Journal》2023年第1期73-81,共9页中华医学杂志（英文版）

基　　金：1.3.5 project for disciplines of excellence,West China Hospital,Sichuan University(No.ZYJC18039);Sichuan Province Regional Innovation Cooperation Project(No.2021YFQ0028);West China Nursing Discipline Development Special Fund Project,Sichuan University(No.HXHL20003)

摘　　要：Background:Synovectomy has been introduced into total knee arthroplasty(TKA)with the aim of relieving pain and inflammation of the synovium.However,there are no long-term,comparative data to evaluate the effect of synovectomy in TKA.This study was aimed at assessing pain,function,and complications in patients undergoing synovectomy during TKA for osteoarthritis(OA)at long-term follow-up.Methods:This was a prospective randomized controlled trial of 42 consecutive patients who underwent staged bilateral TKA.Patients undergoing the first-side TKA were allocated to receive TKA with or without synovectomy followed by a 3-month washout period and crossover to the other strategy for the opposite-side TKA.The overall efficacy of both strategies was evaluated by determination of blood loss,the Knee Society score(KSS),and knee inflammation conditions during a 3-month postoperative period.The postoperative pain,range of motion(ROM),and complications were sequentially evaluated to compare the two groups until 10 years after surgery.Results:At the 10-year follow-up,both groups had a similarly significantly improved ROM(114.88±9.84°vs.114.02±9.43°,t=0.221,P=0.815)and pain relief with no differences between the two groups(1.0[1.0]vs.1.0[1.5],U=789.500,P=0.613).Similar changes in total blood loss,KSS,and knee inflammation were found in both groups during 3 months postoperatively(P>0.05).Additionally,there was no significant difference regarding complications and satisfaction between the two groups(P>0.05).Conclusions:Synovectomy in conjunction with TKA for primary OA does not seem to provide any benefit regarding postoperative pain,ROM,and satisfaction during a 10-year follow-up.In addition,it may not result in more blood loss and increased incidence of long-term complications.Based on our long-term findings,it should not be performed routinely.Trial registration:Chinese Clinical Trial Registry,ChiCTR-INR-16008245;https://www.chictr.org.cn/showproj.aspx?proj=13334.

关 键 词：Randomized controlled trial SYNOVECTOMY Clinical outcomes Total knee arthroplasty 

分 类 号：R687.4[医药卫生—骨科学]