Superior effect of arthroscopic lavage compared with needle aspiration in the treatment of inflammatory arthritis of the knee.
OBJECTIVE
To compare the duration of symptom relief after arthroscopic lavage versus needle aspiration in gonarthritis.


METHODS
A retrospective chart analysis was performed in 50 patients with non-septic inflammatory arthritis of the knee who underwent arthroscopic lavage because of relapsing or persisting arthritis after needle aspiration. The primary outcome measure was the time until symptomatic recurrence of knee synovitis.


RESULTS
Needle aspiration was associated with a 3.0 times greater risk of recurrence of arthritis compared with arthroscopic lavage within 12 months (P<0.001, 95% confidence interval 2.1-4.4). Patients with longer disease duration and who had used more disease-modifying anti-rheumatic drugs (DMARDs) had a significantly lower risk of recurrence of arthritis compared with patients with shorter disease duration and a lower number of previous DMARDs (P=0.04 and 0.02 respectively). Corticosteroids augmented the effect of both interventions.


CONCLUSIONS
Our results indicate that arthroscopic lavage is an effective therapeutic modality in the treatment of inflammatory arthritis of the knee refractory to joint aspiration, especially in patients with longstanding disease.
van Oosterhout
M
M
Department of Rheumatology, C4R, Leiden University Medical Centre, PO Box 9600, 2300 RC Leiden, The Netherlands. M.van_Oosterhaut@lumc.nl
Sont
J K
JK
van Laar
J M
JM
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001168:Arthritis / Q000188:drug therapy / Q000473:pathology / Q000628:therapy*; D001182:Arthroscopy; D001707:Biopsy, Needle; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids; D006801:Humans; D007270:Injections, Intra-Articular; D007719:Knee Joint / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012306:Risk; D013582:Synovial Fluid; D007507:Therapeutic Irrigation
D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D005938:Glucocorticoids