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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

  • Original Article • KNEE - ARTHROPLASTY
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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

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.

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Abbreviations

TKA:

Total knee arthroplasty

VAS:

Visual analogue score

TS:

Total synovectomy

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Authors and Affiliations

  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

    Luis Dario Bernal-Fortich, Joel Galindo-Avalos & Avelino Colin-Vázquez

  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

    Carlos Alberto Aguilar, Adrián H. Rivera-Villa & Pedro Aguilera-Martínez

  3. 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

    Rubén Torres-González

Authors
  1. Luis Dario Bernal-Fortich
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  2. Carlos Alberto Aguilar
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  3. Adrián H. Rivera-Villa
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  4. Joel Galindo-Avalos
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  5. Pedro Aguilera-Martínez
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  6. Rubén Torres-González
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  7. Avelino Colin-Vázquez
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Correspondence to Luis Dario Bernal-Fortich.

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Bernal-Fortich, L.D., Aguilar, C.A., Rivera-Villa, A.H. et al. 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. Eur J Orthop Surg Traumatol 28, 701–706 (2018). https://doi.org/10.1007/s00590-018-2139-5

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  • DOI: https://doi.org/10.1007/s00590-018-2139-5

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