title: The effect of total synovectomy in total knee arthroplasty: a prospective randomized controlled study.
abstract: OBJECTIVE
  The apparent synovial hypertrophy in some cases of noninflammatory knee osteoarthritis suggests that total synovectomy may provide beneficial inflammatory and pain relief after total knee arthroplasty. The aim of the study was to compare the effect of synovectomy on the postoperative pain, bleeding and functional outcome after surgical treatment of knee osteoarthritis.
  
  
  METHODS
  A total of 50 patients with bilateral, non inflammatory, primary knee osteoarthritis were included in the study. Bilateral total knee replacement was performed at the same session. Total synovectomy and total knee arthroplasty (study group) were applied to a randomly selected side, and the total knee arthroplasty alone (as control group) was applied to the contralateral side of the same patient. The overall efficacy of both procedures was assessed postoperatively by determination of blood loss from the drain, pain and functional scores. The Visual Analogue Scale of pain and the Knee Society Knee Score were used to compare the two groups at 3rd, 6th and 12th months, postoperatively.
  
  
  RESULTS
  During the postoperative 48 h, the mean blood loss in the study group (with synovectomy) was significantly higher than the control group (P=0.005). However, in the postoperative follow-up time, there was no significant difference in pain relief and in the Knee Society Score between the two groups.
  
  
  CONCLUSIONS
  Performing synovectomy in patients with primary knee osteoarthritis does not seem to have any clinical advantage besides it might increase blood loss and recurrent hemarthrosis postoperatively. Thus, during arthroplasty surgery, it should not be performed routinely.
authors.affiliation: Department of Orthopaedics and Traumatology, Ataturk Training and Research Hospital, Ankara, Turkey. kilicarslan44@hotmail.com
authors.forename: Kasim
authors.initials: K
authors.lastname: Kilicarslan
authors.forename: Nadir
authors.initials: N
authors.lastname: Yalcin
authors.forename: Hakan
authors.initials: H
authors.lastname: Cicek
authors.forename: Yunus
authors.initials: Y
authors.lastname: Dogramaci
authors.forename: Mahmut
authors.initials: M
authors.lastname: Ugurlu
authors.forename: Hamdi
authors.initials: H
authors.lastname: Ozkan
authors.forename: Hasan
authors.initials: H
authors.lastname: Yildirim
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects / Q000379:methods*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000601:surgery*; D010147:Pain Measurement; D011182:Postoperative Care / Q000379:methods; D011183:Postoperative Complications / Q000503:physiopathology; D011446:Prospective Studies; D011859:Radiography; D016059:Range of Motion, Articular / Q000502:physiology*; D020127:Recovery of Function; D012016:Reference Values; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D000074402:Synovectomy; D016896:Treatment Outcome