A prospective randomized trial of total synovectomy versus limited synovectomy in primary total knee arthroplasty: evaluation of bleeding, postoperative pain, and quality of life with SF-12 v2

Autor: Avelino Colin-Vázquez, Luis Dario Bernal-Fortich, Carlos Aguilar, Rubén Torres-González, Joel Galindo-Avalos, AH Rivera-Villa, Pedro Aguilera-Martínez
Rok vydání: 2018
Předmět:
Zdroj: European Journal of Orthopaedic Surgery & Traumatology. 28:701-706
ISSN: 1432-1068
1633-8065
DOI: 10.1007/s00590-018-2139-5
Popis: 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. 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. 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. 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.
Databáze: OpenAIRE
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