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BioRxiv : the Preprint Server For... Aug 2023Temporomandibular Disorders (TMDs) is present in 33% of the U.S. population. Currently available animal models do not faithfully simulate the native disease progression...
Temporomandibular Disorders (TMDs) is present in 33% of the U.S. population. Currently available animal models do not faithfully simulate the native disease progression of TMJ OA. The initiation of TMJ OA requires both local trauma and systemic inflammation. In this study, we present a novel mouse model which reproduces these two conditions. This is achieved by a procedure involving both synovectomy (local trauma) and a distant burn injury (systemic inflammation). Its efficacy at inducing TMJ OA was assessed with histomorphology and radiographic evaluation at 1,3, and 9 weeks after the procedure. We found that burn/synovectomy mice demonstrated significantly more degenerative changes in TMJ than uninjured control mice or synovotomy mice. The observed histology in burn/synoectomy mice mimicked native TMJ OA disease progression in a faithful manner. This animal model is invaluable in future research of the mechanism and risk factors of TMJ OA.
PubMed: 37609135
DOI: 10.1101/2023.08.07.552340 -
Journal of Orthopaedic Surgery and... Mar 2018Many studies have proposed synovectomy during total knee arthroplasty (TKA) to reduce pain after TKA. The aim of this study was to assess the outcomes of synovectomy for... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Many studies have proposed synovectomy during total knee arthroplasty (TKA) to reduce pain after TKA. The aim of this study was to assess the outcomes of synovectomy for treating of TKA through a meta-analysis.
METHODS
Relevant clinical studies on synovectomy and without synovectomy were retrieved through searching the databases PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials up to January 2018. Studies that investigated the comparison of pain scores, total blood loss, range of motion, functional Knee Society Scores (KSSs), clinical KSSs, and operating time and provided sufficient data of interest were included in this meta-analysis. Stata 12.0 was used for meta-analysis.
RESULTS
Ten randomized controlled trials (RCTs) were finally included in this meta-analysis. Final results indicated that there was no significant difference between the pain scores, range of motion, functional Knee Society Scores (KSSs), and clinical KSSs (P > 0.05). However, synovectomy was associated with an increase of the total blood loss compared to patients without synovectomy (weighted mean difference (WMD) = 116.71, 95% confidence interval (CI) 78.63, 154.79, P = 0.000). Pooled results indicated that synovectomy was associated with an increase of the operating time (WMD = 15.44, 95% CI 2.67, 28.21, P = 0.018).
CONCLUSIONS
Current evidence indicates that synovectomy has no effects on the final clinical outcomes for patients undergoing TKA. It will increase the total blood loss and the operating time during TKA.
Topics: Arthroplasty, Replacement, Knee; Blood Loss, Surgical; Humans; Knee Joint; Operative Time; Osteoarthritis, Knee; Pain, Postoperative; Range of Motion, Articular; Synovectomy
PubMed: 29530063
DOI: 10.1186/s13018-018-0752-y -
SpringerPlus 2015The aim of this study was to investigate remission and biologic-free remission after orthopaedic surgery and related clinical factors in non-responder to infliximab for...
The aim of this study was to investigate remission and biologic-free remission after orthopaedic surgery and related clinical factors in non-responder to infliximab for rheumatoid arthritis (RA). We analyzed 74 patients who were treated with 3 mg/kg infliximab and methotrexate and underwent orthopaedic surgery after non-responder to infliximab with disease activity score (DAS) 28 (CRP) of ≥3.2. The rates of remission and biologic-free remission at 52 weeks after orthopaedic surgery were investigated and the clinical factors related to remission and biologic-free remission were analyzed by logistic regression and receiver-operating characteristic analyses. The rates of total remission and biologic-free remission were 37/74 (50 %) and 9/74 (12.2 %), respectively. Regarding orthopaedic surgery, the rates of remission and biologic-free remission were 25/38 (65.8 %) and 7/38 (18.4 %) for synovectomy, 7/20 (35 %) and 0/20 (0 %) for arthroplasty, and 5/16 (31.3 %) and 2/16 12.5) for others including spine surgery and foot surgery. DAS28(CRP) at baseline was significantly related to both remission and biologic-free remission. Prednisolone was negatively associated with remission, and DAS28(CRP) was related to biologic-free remission by logistic regression analyses. DAS28(CRP) below 3.7 was cutoff point for acquiring biologic-free remission of non-responder to infliximab after orthopaedic surgery. Therefore orthopaedic surgery may be effective to obtain remission or biologic-free remission in RA patients treated with biologics.
PubMed: 26543742
DOI: 10.1186/s40064-015-1397-5 -
Journal of Shoulder and Elbow Surgery Mar 2022Silicone radial head prostheses (SRHP) have a reputation of acceptable initial function but failure in the medium to long term as a result of the disintegration of the...
INTRODUCTION
Silicone radial head prostheses (SRHP) have a reputation of acceptable initial function but failure in the medium to long term as a result of the disintegration of the silicone material. Damaged SRHP can result in a silicone-induced synovitis and destruction of the joint. Early removal of damaged SRHP may prevent joint destruction. Literature is scarce; there are no studies describing early symptoms associated with clinical failure of SRHP and very few studies on appropriate treatment of destructed SRHP. The aim of this study was to describe the clinical course of failing SRHP and to provide practical guidance for treatment.
METHODS
Fifteen consecutive cases of failed SRHP, operated between 2005 and 2020, were retrospectively reviewed, using patient logs, radiographic results, and a questionnaire. Relevant data concerning pre- and postoperative complaints, function, and surgical details were gathered. Using the questionnaire, retrospective and current patient reported outcomes including Single Assessment Numeric Evaluation (SANE) scores, pain, instability, and range of motion were analyzed.
RESULTS
The average time between implantation of the SRHP until outpatient presentation was 16 years. The average recalled SANE score before start of complaints was 8.6 out of 10 points. In 4 patients, the onset of complaints was preceded by a trauma. Five patients had symptoms for more than a year, and 9 patients for several months. Progressive pain in the elbow and/or wrist and mechanical symptoms were early and prominent symptoms of failure. Clinical signs of synovitis were frequently present. The majority of patients had a slow but progressive onset of complaints over several months before presentation. Twelve of 15 cases of failed SRHP were surgically treated. Fragmentation of the implant, osteoarthritis, and synovitis were found in all surgically treated cases. Both surgical removal and synovectomy alone, and revision to a new radial head prosthesis resulted in good medium-term outcomes with a mean SANE score of 7.3 points at 8.4 years of follow-up. Postoperative extension lags and mild instability were frequently mentioned as a reason for reimplantation of a metallic radial head implant and removal of the radial head alone, respectively.
CONCLUSION
Both patients and physicians should be aware of early symptoms of a failing SRHP. Adequate recognition, radiographic evaluation, and early intervention may favor outcomes of failing SRHP. Surgical removal is easy to perform. In selected cases, revision of the radial head prosthesis may be considered. Both of these treatment strategies resulted in satisfying outcomes.
Topics: Elbow Joint; Elbow Prosthesis; Humans; Radius Fractures; Range of Motion, Articular; Retrospective Studies; Silicones; Treatment Outcome; Elbow Injuries
PubMed: 34871730
DOI: 10.1016/j.jse.2021.10.043 -
Annals of Medicine and Surgery (2012) Aug 2023Synovial chondromatosis is a rare condition characterized by the chondral proliferation of synovium forming loose bodies which can lead to pain, swelling, and decreased...
UNLABELLED
Synovial chondromatosis is a rare condition characterized by the chondral proliferation of synovium forming loose bodies which can lead to pain, swelling, and decreased range of movement of the affected joint.
CASE PRESENTATION
Here the authors report a case of eighteen years lady with recurrent hip synovial chondromatosis who was treated previously with hip arthrotomy and loose bodies removal and now she underwent arthroscopic loose bodies removal with partial synovectomy.
CLINICAL DISCUSSION
In comparison to arthrotomy of the hip, arthroscopic management is a minimally invasive surgery that is associated with decreased postoperative pain, earlier improvement in range of motion, a shorter course of rehabilitation, and overall lower morbidity.
CONCLUSION
Thus, the authors recommend arthroscopic removal of the loose bodies and partial synovectomy for the management of synovial chondromatosis of the hip.
PubMed: 37554870
DOI: 10.1097/MS9.0000000000000999 -
Arthroscopy Techniques Jun 2017Peroneal tenosynovitis usually responds to conservative therapy. Early diagnosis and management are imperative because improper or delayed diagnosis and treatment of...
Peroneal tenosynovitis usually responds to conservative therapy. Early diagnosis and management are imperative because improper or delayed diagnosis and treatment of peroneal tenosynovitis may lead to progression of the tenosynovitis to peroneal tendon rupture, ultimately limiting the benefit of nonoperative treatment. For refractory cases, endoscopic tenosynovectomy is indicated. The purpose of this Technical Note is to report a minimally invasive approach to perform a synovectomy of zones 1 and 2 of the peroneal tendon sheath.
PubMed: 28706847
DOI: 10.1016/j.eats.2017.02.021 -
World Journal of Orthopedics Jun 2024In this case report featured in , Kelmer describe a rare finding of a 28-year-old female patient who presented with a recurrent fibroreactive nodule 7 months following...
In this case report featured in , Kelmer describe a rare finding of a 28-year-old female patient who presented with a recurrent fibroreactive nodule 7 months following the resection of a primary cyclops lesion, suggesting recurrent cyclops syndrome. The patient had undergone an initial anterior cruciate ligament reconstruction for a non-contact right knee injury and reported successful recovery. Two years later, the patient sustained a repeat right knee injury followed by a positive McMurray test and acute pain with terminal extension. Arthroscopic synovectomy confirmed magnetic resonance imaging (MRI) finding of a cyclops lesion, which was surgically removed. Seven months postoperatively, the patient reported stiffness and difficulty with terminal extension. Repeat MRI indicated a recurrent cyclops lesion, which was surgically resected. Following resection of the second lesion, the patient underwent physical therapy and achieved full range of motion, maintaining complete recovery 19 months postoperatively. Recurrent cyclops lesions have rarely been reported in the literature, and this article is novel in its report of recurrent cyclops syndrome following a bone-patellar tendon-bone allograft. The presentation of this unusual finding exposes a need for further investigation of cyclops lesion pathology, which will aid its prevention and treatment.
PubMed: 38947257
DOI: 10.5312/wjo.v15.i6.495 -
Zeitschrift Fur Rheumatologie Mar 2016Pigmented villonodular synovitis (PVNS) describes a rare disease caused by an abnormal proliferation of the synovial membrane in large and small joints. In order to... (Review)
Review
BACKGROUND
Pigmented villonodular synovitis (PVNS) describes a rare disease caused by an abnormal proliferation of the synovial membrane in large and small joints. In order to achieve an optimal result of treatment it is necessary to carry out specific diagnostics and a targeted therapy approach.
OBJECTIVE
This article gives a review of the epidemiology, etiopathogenesis and diagnostic management of PVNS as well as presenting the current therapy and treatment recommendations.
MATERIAL AND METHODS
A systematic search of the literature was performed in the databank of the National Center for Biotechnology Information ( http://www.ncbi.nlm.nih.gov/pubmed ). The search targeted randomized clinical and experimental studies, systematic and non-systematic review articles, expert opinions and case reports related to PVNS, independent of the level of evidence attained by each study.
RESULTS
The differential diagnosis of PVNS should be considered in cases of recurrent hemorrhagic joint effusions. The cause of the disease has not yet been exactly clarified. The final diagnosis can ultimately only be confirmed by histological investigations. In order to obtain representative histological tissue samples for the diagnosis, magnetic resonance imaging (MRI) with the appropriate heme sequences should be carried out prior to taking samples. The management of PVNS is often difficult due to the high risk of recurrence depending on the various forms. In view of the high rate of recurrence, therapy should include a complete synovectomy.
CONCLUSION
For the surgical approach arthroscopic and open procedures have been described, which are currently controversially discussed with respect to the complication and recurrence rates. Adjuvant interventional therapy forms, such as radiosynoviorthesis are recommended to reduce the recurrence rate.
Topics: Arthroscopy; Biopsy; Combined Modality Therapy; Diagnosis, Differential; Edema; Humans; Immunosuppressive Agents; Magnetic Resonance Imaging; Prevalence; Radiotherapy; Rare Diseases; Symptom Assessment; Synovitis, Pigmented Villonodular
PubMed: 26768272
DOI: 10.1007/s00393-015-0028-4 -
Lupus Science & Medicine Jan 2024With scarce data on the need and type of joint surgery in SLE, we investigated the long-term rates and underlying causes for arthroplasty, arthrodesis and synovectomy in...
AIM
With scarce data on the need and type of joint surgery in SLE, we investigated the long-term rates and underlying causes for arthroplasty, arthrodesis and synovectomy in patients with SLE.
METHODS
Procedure dates for arthroplasty, arthrodesis or synovectomy were retrieved from the state-wide Hospital Morbidity Data Collection between 1985 and 2015 for patients with SLE (n=1855) and propensity-matched controls (n=12 840). Patients with SLE with ≥two additional diagnostic codes for rheumatoid arthritis were classified as rhupus. ORs and incidence rates (IRs) per 100 person-years for joint procedures (JPs) were compared among patients with rhupus, patients with other SLE and controls across three study decades by regression analysis.
RESULTS
More patients with SLE than controls underwent a JP (11.6% vs 1.3%; OR 10.8, CI 8.86 to 13.24) with a higher IR for JP in patients with SLE (1.9 vs 0.1, rate ratio 19.9, CI 16.83 to 23.55). Among patients with SLE, patients with rhupus (n=120, 60.5%) had the highest odds of arthroplasty (OR 4.49, CI 2.87 to 6.92), arthrodesis (OR 6.64, CI 3.28 to 12.97) and synovectomy (OR 9.02,CI 4.32 to 18.23). Over time, the IR for overall JP in patients with rhupus was unchanged (8.7 to 8.6, R=0.004, p=0.98), although the IR for avascular necrosis underlying arthroplasty decreased for all patients with SLE (0.52 to 0.10, p=0.02). Patients with other SLE also had significantly higher OR and IR for all three JPs than controls with insignificant decreases in synovectomy and increases in arthroplasty over time in this group.
CONCLUSIONS
The overall burden of joint surgery in SLE is high and despite a reduction in avascular necrosis, arthroplasty and arthrodesis rates have not decreased over time. These data indicate a need for increased efforts to prevent joint damage in patients with lupus.
Topics: Humans; Cohort Studies; Lupus Erythematosus, Systemic; Arthritis, Rheumatoid; Longitudinal Studies; Necrosis
PubMed: 38199862
DOI: 10.1136/lupus-2023-001045 -
Rhode Island Medical Journal (2013) May 2020
Review
Topics: Arthritis, Rheumatoid; Arthrodesis; Arthroplasty; Finger Joint; Hand Deformities, Acquired; Humans; Radiography; Synovectomy; Synovitis; Tendons
PubMed: 32357591
DOI: No ID Found