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Wrist synovectomy in juvenile chronic arthritis (JCA)
G Hanff1, C Sollerman, R Elborgh
1Department of Orthopedic Surgery, Lund University Hospital, Sweden.
Scandinavian Journal of Rheumatology
|January 1, 1990
Summary
Synovectomy improved wrist function in juvenile chronic arthritis patients, with many experiencing pain relief. Results were comparable to those in adult arthritis patients, suggesting this surgical option is viable for JCA.
Area of Science:
- Orthopedics
- Rheumatology
- Pediatric Surgery
Background:
- Juvenile chronic arthritis (JCA) can significantly impact wrist joint function and cause pain.
- Surgical intervention, such as synovectomy, is considered for persistent symptoms unresponsive to conservative treatment.
Purpose of the Study:
- To evaluate the long-term outcomes of wrist synovectomy in patients diagnosed with juvenile chronic arthritis.
- To compare the efficacy of wrist synovectomy in JCA patients with outcomes reported in adult arthritis patients.
Main Methods:
- Synovectomy was performed on 20 wrist joints across 15 JCA patients, involving the radiocarpal, ulnar head, and intercarpal joints without ulnar head resection.
- Outcomes were assessed 3 years (0.5-5 years) post-surgery, including pain levels, grip strength, range of motion, and radiographic changes.
Main Results:
- Of the 15 re-examined cases, 12 showed improvement, with 7 becoming completely pain-free.
- A mean improvement in grip strength (0.2 kp/cm2) and a decrease in range of motion (10 degrees flexion/extension) were observed.
- Radiographic deterioration was noted in approximately half of the wrists post-surgery.
Conclusions:
- Wrist synovectomy can lead to significant pain reduction and functional improvement in JCA patients.
- The outcomes of wrist synovectomy in JCA patients appear comparable to those reported in adult patients with arthritis.
- Further deterioration on radiographic evaluation warrants consideration in the long-term management of JCA patients undergoing synovectomy.