Luis Dario Bernal-Fortich1, Carlos Alberto Aguilar2, Adrián H Rivera-Villa2, Joel Galindo-Avalos3, Pedro Aguilera-Martínez2, Rubén Torres-González4, Avelino Colin-Vázquez3. 1. UMAE "Dr. Victorio de la Fuente Narváez" IMSS-UNAM, Av. Colector 15 s/n Esq. Av. Instituto Politécnico Nacional. Col. Magdalena de las Salinas, Delg. Gustavo A. Madero, C.P. 07760, Mexico, Mexico. bernalfortichortopedia@gmail.com. 2. Joint Replacement Surgery Department, UMAE Traumatology, Orthopedics and Rehabilitation "Dr. Victorio de la Fuente Narváez" IMSS, Av. Colector 15 s/n Esq. Av. Instituto Politécnico Nacional. Col. Magdalena de las Salinas, Delg. Gustavo A. Madero, C.P. 07760, Mexico, Mexico. 3. UMAE "Dr. Victorio de la Fuente Narváez" IMSS-UNAM, Av. Colector 15 s/n Esq. Av. Instituto Politécnico Nacional. Col. Magdalena de las Salinas, Delg. Gustavo A. Madero, C.P. 07760, Mexico, Mexico. 4. Health Education and Research Department, UMAE Traumatology, Orthopedics and Rehabilitation "Dr. Victorio de la Fuente Narváez" IMSS, Av. Colector 15 s/n Esq. Av. Instituto Politécnico Nacional. Col. Magdalena de las Salinas, Delg. Gustavo A. Madero, C.P. 07760, Mexico, Mexico.
Abstract
BACKGROUND: During total knee arthroplasty (TKA), total synovectomy (TS) as a part of the surgical technique has been proposed to reduce the inflammatory tissue after the procedure, but there is a controversy about it because of the risk of major postsurgical bleeding. The aim of this study was to compare postoperative bleeding, pain, and health-related quality of life (HRQOL) after a TKA when a TS is performed and when it is not. METHODS: The difference in pre and postoperative hemoglobin was measured, as well as postoperative pain using visual analogue scale (VAS) scores at 24 and 48 h post-surgical, HRQOL was measured prior to surgery and at one year using the SF-12V2 questionnaire. RESULTS: We assessed a total of 148 patients (73 for TS and 75 for limited synovectomy). We have found a difference of 0.9 mg/dl of pre- and postoperative hemoglobin between both groups, with a higher bleeding amount for the TS group (P = 0.0000647); VAS scores were slightly lower for the TS group at 24 and 48 h after surgery, but not relevant. The TS group required transfusion in 13.3% and the limited synovectomy group in 6.8%. No significant differences in HRQOL were found in both groups at 1 year follow-up. CONCLUSIONS: Performing a TS in TKA in patients with osteoarthrosis does not result in a relevant lower postoperative pain, or in an improvement in HRQOL, and it does increase the amount of bleeding after the procedure.
RCT Entities:
BACKGROUND: During total knee arthroplasty (TKA), total synovectomy (TS) as a part of the surgical technique has been proposed to reduce the inflammatory tissue after the procedure, but there is a controversy about it because of the risk of major postsurgical bleeding. The aim of this study was to compare postoperative bleeding, pain, and health-related quality of life (HRQOL) after a TKA when a TS is performed and when it is not. METHODS: The difference in pre and postoperative hemoglobin was measured, as well as postoperative pain using visual analogue scale (VAS) scores at 24 and 48 h post-surgical, HRQOL was measured prior to surgery and at one year using the SF-12V2 questionnaire. RESULTS: We assessed a total of 148 patients (73 for TS and 75 for limited synovectomy). We have found a difference of 0.9 mg/dl of pre- and postoperative hemoglobin between both groups, with a higher bleeding amount for the TS group (P = 0.0000647); VAS scores were slightly lower for the TS group at 24 and 48 h after surgery, but not relevant. The TS group required transfusion in 13.3% and the limited synovectomy group in 6.8%. No significant differences in HRQOL were found in both groups at 1 year follow-up. CONCLUSIONS: Performing a TS in TKA in patients with osteoarthrosis does not result in a relevant lower postoperative pain, or in an improvement in HRQOL, and it does increase the amount of bleeding after the procedure.
Entities:
Keywords:
Health-related quality of life; Osteoarthrosis; Synovectomy; Total knee arthroplasty
Authors: Daniel D Galat; Scott C McGovern; Dirk R Larson; Jeffrey R Harrington; Arlen D Hanssen; Henry D Clarke Journal: J Bone Joint Surg Am Date: 2009-01 Impact factor: 5.284