Background The study assesses the therapeutic result from a single application of local corticosteroid (betamethasone 7 mg) seven days after the performance of an arthroscopic synovectomy of the knee joint in patients with rheumatoid arthritis (RA).

Objectives An arthroscopic shaver-synovectomy with a consecutive tidal lavage with 4 – 5L saline was performed in 73 RA patients (51F/22M) with mean disease duration 4,5 (± 1.8) years and active synovitis of the knee joints. In 23 patient (15F/8M) after the arthroscopic synovectomy (AS) an application of a local corticosteroid was not performed (control group).

Methods The assessment of the results was done on 1st, 3rd and on 6th month after AS according to the Knee Society Rating System, using a scale for assessment of the knee joint in respect of the changes of the pain, range of motion (ROM), joint stability and some functional parameters.

Results A higher degree of reducing of the pain, improvement in the joint stability of the gait and of the ability of climbing and descending scales in all patients with local application of corticosteroid after AS was found compared to controls (p < 0.001)

Conclusion The results confirm the better effect from the administration of a local corticosteroid one week after an arthroscopic synovectomy in rheumatoid knee synovitis.

References

1. Sharma A, Baethge BA, Acebes JC, et al. Arthroscopic lavage treatment in rheumatoid arthritis of the knee. J Rheumatol. 1996;23(11):1872–4

2. Srinivasan A, Amos M, Webley M. The effect of joint washout of steroid injection compared with either joint washout of steroid injection alone in rheumatoid knee effusion. Br J Rheumatol. 1995;1:219–27