AB0424 A RETROSPECTIVE STUDY OF ARTHROSCOPIC SYNOVECTOMY FOR REFRACTORY KNEE ARTHRITIS COMPLICATED WITH POPLITEAL CYST
Authors: peng han, Jian Zhu, Jianglin Zhang, Feng Huang
Journal: Annals of the Rheumatic Diseases (2019)

<h3>Background</h3> Baker's cyst or popliteal cyst is the most common mass surrounding the knee joint that results from inflammatory knee arthritis. With increasing number of arthroscopic synovectomy performed for refractory knee arthritis annually, we aim to explore its value in baker's cyst treatment.<sup>[1]</sup> <h3>Objectives</h3> To investigate the efficacy of arthroscopic synovectomy on refractory knee arthritis complicated with popliteal cyst. <h3>Methods</h3> A retrospective analysis of 153 patients (RA= 95, SpA= 58) with refractory knee arthritis, underwent knee arthroscopic synovectomy in our hospital from 2010 to 2017, was performed. Among them, 20 patients (RA= 16, SpA= 4) complicated with popliteal cyst. We compared the changes in inflammation makers, disease activity score, imaging manifestations, symptoms, the rate and the grading of popliteal cyst<sup>[2]</sup> before and after the operation to evaluate the efficacy of knee arthroscopic synovectomy.<sup>[3]</sup> Results: inflammation markers[ESR(49.42±32.54 <i>vs</i> 24.46±24.17, <i>P</i>&lt;0.001), CRP(8.55±16.43 <i>vs</i> 5.60±22.45, <i>P</i>&lt;0.001)], Rheumatoid Factor(191.29±373.72<i> vs</i> 74.90±158.31, <i>P</i>&lt;0.001), DAS28 score(4.67±1.25 <i>vs</i> 2.81±1.23, <i>P</i>&lt;0.001), knee joint discomfort score(5.2±1.7 <i>vs</i> 1.9±1.5, <i>P</i>&lt;0.001) and the amount of knee joint effusion by ultrasound scanning (<i>P</i>&lt;0.05) in 95 RA patients were significantly decreased compared to those before the operation; Inflammation markers[ESR(36.76±28.71 <i>vs</i> 21.19±9.79, <i>P</i>&lt;0.001), CRP(21.19±9.79 <i>vs</i> 3.36±6.44, <i>P</i>&lt;0.001)], knee discomfort score(4.48±1.06 <i>vs</i> 2.51±1.54, <i>P</i>&lt;0.05), back pain VAS score(2.74±2.88 <i>vs</i> 1.56±1.70, <i>P</i>&lt;0.001), and the amount of knee joint effusion by ultrasound scanning (<i>P</i>&lt;0.001) in 58 SpA patients were significantly lower than those before the operation; the rate(16.84% vs 6.32%, <i>P</i>=0.023) and grading(<i>P</i>=0.007) of popliteal cyst in RA were decreased after the operation; No statistically difference was observed in the rate(6.90% <i>vs</i> 5.17%, <i>P</i>=0.697) of popliteal cyst in SpA, but the grading were all decreased in 4 patients. <h3>Conclusion</h3> This study provide evidence that knee arthroscopic synovectomy has a good effect for refractory knee arthritis, which can reduce disease activity, improve joint symptoms and decrease the grading of popliteal cyst. <h3>References</h3> [1] Zhou X N, Li B, Wang J S, et al. Surgical treatment of popliteal cyst: a systematic review and meta-analysis[J]. Journal of Orthopaedic Surgery &amp; Research, 2016, 11(1):22. [2] Rauschning W, Lindgren P G. Popliteal cysts (Baker's cysts) in adults. I. Clinical and roentgenological results of operative excision.[J]. Acta Orthop Scand, 1979, 50(5):583-91. [3] [3]Rupp S, Seil R, Jochum P, et al. Popliteal cysts in adults. Prevalence, associated intraarticular lesions, and results after arthroscopic treatment[J]. Am J Sports Med, 2002, 30(30):112-115. <h3>Disclosure of Interests</h3> None declared