title: Effectiveness of arthroscopic elbow synovectomy in rheumatoid arthritis patients: Long-term follow-up of clinical and functional outcomes.
abstract: OBJECTIVE
  To determine the long-term clinical and functional results of arthroscopic elbow synovectomy in rheumatoid arthritis patients with refractory elbow synovitis in terms of improvement in pain, function, and active range of motion (AROM) or arc of motion.
  
  
  METHODS
  Fifteen rheumatoid elbows in 13 patients, not responding to DMARD therapy and with radiological changes not more than Larsen grade 3 were taken, who underwent arthroscopic elbow synovectomy. The main outcome measured in forms of Mayo Elbow Performance Scale (MEPS) score, measurement of pain using a Visual Analogue Scale (VAS), radiological angles of elbow, disease activity score (DAS-28), arc of motions (AOM) and complications, which were assessed at follow-up periods of 6 months, 24 months, and 30 months. Statistical analysis was done both qualitatively and quantitatively. Mann-WhitneyUtest, chi-square test, and Studentttest were used as the statistical test for determining significance.
  
  
  RESULTS
  In the study group, the improvement was sustained and significant as compared to baseline (VAS 1.28, MEPS 81.07 and mean flexion range 85°) (pvalue <0.001). No significant complications were encountered postoperatively after elbow synovectomy.
  
  
  CONCLUSIONS
  The study assesses the long-term results of arthroscopic synovectomy in elbow synovitis secondary to rheumatoid arthritis with significant results favoring arthroscopic synovectomy.
authors.affiliation: Department of Orthopaedics, Sports Injury Centre, New Delhi, India.
authors.forename: Vivek
authors.initials: V
authors.lastname: Shankar
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Pankaj
authors.initials: P
authors.lastname: Sharma
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Ravi
authors.initials: R
authors.lastname: Mittal
authors.affiliation: Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Samarth
authors.initials: S
authors.lastname: Mittal
authors.affiliation: Department of Rheumatology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Uma
authors.initials: U
authors.lastname: Kumar
authors.affiliation: Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.
authors.forename: Shivanand
authors.initials: S
authors.lastname: Gamanagatti
keywords: Arc of motion (AOM); Arthroscopic synovectomy; Disease activity score (DAS-28); Larsen grading; Mayo Elbow Performance Scale (MEPS); Visual Analogue Scale (VAS) score