Laser Assisted Arthroscopic Surgery for Bilateral Psoriatic Arthropathy of Knee in a Middle Age Housewife

Joint involvement is common in patients with Psoriasis. Although the mainstay of treatment is drug therapy, we may be required to intervene surgically in patients with florid, painful synovitis. This is done to obtain pain relief and functional improvement, as also to prevent destruction of articular cartilage by the synovial invasion. This philosophy is similar to what we use in Rheumatoid Arthritis. Obviously now, Arthroscopic surgery is the method of choice and we do not even discuss the possibility of an open debridement of the joint, as was done in the past. However, in Rheumatoid as well as in Psoriatic arthritis, the major problem is the extreme vascularity of the diseased tissue, leading to reactionary post-operative haemorrhage when we use conventional operating tools. This can compromise the rehabilitation process to a large extent. With the advent of LASER, this issue is taken care of. We can now hope for rapid return to function, provided we intervene early, provided the articular cartilage is largely intact and if we can ensure excellent control of disease with drug therapy. We present a typical case of bilateral knee involvement in Psoriasis in a middle-aged housewife to clearly illustrate the benefit of using modern surgical modalities.