S56 SHORT-TERM RESULTS OF SYNOVECTOMY OF THE FINGER JOINTS IN RHEUMATOID ARTHRITIS

Abstract

Purpose: Rheumatoid arthritis (RA) frequently affects the finger joints. Persistent synovitis is believed to cause not only bone destruction but also various deformities of the hands. For this reason, synovectomy of the finger joints is attempted when chronic swelling of the synovium of finger joints does not respond to any conservative treatment. The purpose of this study is to evaluate the effectiveness of surgical synovectomy of finger joints in RA patients.

Method: Forty-six finger joints (MP 24; Steinbrocker Stage II: 8, Stage III: 16) (PIP 22; Stage I: 5, Stage II: 9, Stage III: 8) of 20 patients with rheumatoid arthritis who had synovectomy were examined at an average of 20 months follow-up (range 14–43 months). The active motion exercises of the operated fingers started as early as 2 or 3 days after surgery. The results of synovectomy in these patients were evaluated by pain, range of motion, and radiograph.

Results: Pain was relieved (Visual analogue scale MP: 6.5→1.4, PIP: 6.2→0.7), swelling was diminished in all and only a little loss of motion was observed (arc of motion MP: 59.8→53.4, PIP: 75.5→69.6) after surgery. Radiological bone changes progressed in 4 (17%) MP and 3 (14%) PIP joints. Deformities (ulnar drift or subluxation) after surgery developed in 3 (12%) MP-joints.

Conclusion: Synovectomy performed on finger joints of RA patients were evaluated. From the results of this clinical study we recommend synovectomy of finger joints in RA patients before bone changes, when chronic synovitis of finger joints does not respond to any conservative treatment.