Assesment of Arthroscopic Elbow Synovectomy Outcomes in Patients with Rheumatoid Arthritis

OBJECTIVE To review functional outcomes of arthroscopic elbow synovectomy in patients with rheumatoid arthritis. METHODS Between May 1999 and December 2005, 15 patients were submitted to elbow synovectomy using an arthroscopic approach. Three cases were bilateral, totaling 18 elbows. There were two male and 13 female patients. The mean age was 44 years and five months. The mean time of previous diagnosis was six years and eight months. All patients reported preoperative pain, and on seven elbows, instability was present. The mean preoperative values for joint motion were: flexion, 118°; extension, -24°, supine, 80°, and; prone, 71°. RESULT The mean postoperative follow-up time was 39 months. The mean postoperative joint motion was 133° for flexion, -20° for extension, 84° supine, and 78° prone. On nine elbows (50%) an improved postoperative range of motion was reported, reaching functional levels. Twelve cases (66.6%) showed pain resolution or improvement to a level not interfering on the activities of daily life. According to Bruce's assessment method, the results were as follows: seven excellent, three good, two fair and six poor results, with an average of 85.5 points. Synovitis recurrence was found in six cases (33.3%), and evolution to osteoarthrosis was found in four (22.2%). CONCLUSION Arthroscopic elbow synovectomy in patients with rheumatoid arthritis leads to pain improvement in 66.6% of the cases; however, it does not cause a significant range of motion improvement.