The Journal of Bone and Joint Surgery, Vol 67, Issue 1 8-15, Copyright © 1985 by Journal of Bone and Joint Surgery, Inc
Late results of synovectomy in juvenile rheumatoid arthritis
ST Jacobsen, JE Levinson and AH Crawford
We reviewed the records of 251 patients whose cases were diagnosed between
1958 and 1978 at the Children's Hospital Medical Center Special Treatment
Center for Juvenile Arthritis. We used a computerized system that included
retrieval of data on range of motion, pain, joint swelling, functional
capacity, and radiographic changes at each six-month visit over the years
that the patient was followed. For the patients who were operated on, the
radiographic information was evaluated preoperatively and at the last
radiographic follow-up (average, six years after operation). The data bank
contained postoperative radiographic information for thirty-two of the
joints that had been operated on. We reviewed the late results of forty-one
synovectomies in thirty children. The data included range of motion,
swelling, and pain before operation, at one and two years after operation,
and at an average of 7.1 years of follow-up. There were few if any benefits
from the operation with reference to pain or improvement of range of
motion, but it did seem to provide permanent relief of the joint swelling.
Furthermore, radiographic deterioration seemed to continue in the joints
that had been operated on if they already had radiographic changes at the
time of operation (late synovectomy). In the joints without radiographic
changes at the time of operation (early synovectomy), there seemed to be a
continuation of deterioration in those affected by polyarticular disease,
while the changes were less pronounced in those affected by pauciarticular
disease. We undertook this study with a positive attitude toward
synovectomy in the treatment of juvenile rheumatoid arthritis.(ABSTRACT
TRUNCATED AT 250 WORDS)
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