No-synovectomy improves the health-related quality of life after total knee arthroplasty: A randomised clinical trial

Background This study assessed the clinical outcomes of total knee replacement with and without synovectomy among patients with osteoarthritis. Methods A randomised controlled trial of 70 patients with advanced knee osteoarthritis was conducted by individually randomizing (simple randomization) patients to either no synovectomy (group 1 n=35) or synovectomy (group 2 n=35). Clinical outcomes were assessed by Western Ontario and McMaster Universities Arthritis Index, WOMAC score, knee pain by visual analogue score, health related quality of life by Short Form 12, postoperative blood loss, and hemoglobin levels immediately after surgery and one year postoperative. Results Postoperatively, The WOMAC score was 87 (82, 97) in group 1 and 84 (76, 96) in group 2. The VAS score was 6 (5.00, 8.00) and 7 (5.00, 8.00) in group 1 and 2 respectively. The physical composite score (PCS) of the SF-12 score was 52 (46, 56) in group 1 and 50 (43, 54) in group 2. The mental composite score of the SF-12 was 58(55, 61) and 51 (45, 57) in group 1 and 2 respectively with significant difference between groups. The median hemoglobin drop was 1.7 (1.35, 2.00) grams in group 1 and 3 (2.45, 3.30) grams in group 2. The median drain blood loss was 250 ml (200, 350) and 800 ml (450, 1200) in group 1 and 2 respectively. Patients in group 1 had a better flexion range than group 2. Conclusion Total knee arthroplasty performed without synovectomy reduces postoperative blood loss, improves the flexion range and patients’ quality of life scores.