Arthroscopic Debridement After Total Knee Arthroplasty Is More Effective for Synovitis Than for Ankylosis

Purpose

To investigate the effects of arthroscopy surgery on ankylosis and synovitis after total knee arthroplasty (TKA), with patient satisfaction as the main outcome measure.

Methods

A single surgeon’s database was queried for all knee arthroscopy procedures done from 2002 to 2024 using the International Classification of Diseases, Ninth and Tenth Revision, codes for ankylosis or synovitis and Current Procedural Terminology codes 29884 and 29876. Patients were excluded if they did not have a previous TKA, had a TKA but arthroscopy was done for multiple or other indications, were <2 months from TKA, lacked medical records, or were worker’s compensation cases. Patients were separated into either the ankylosis group or the synovitis group. A patient satisfaction survey was collected at first and last follow-up and asked individuals to rate their condition as “better,” “unchanged,” or “worse” after arthroscopy. A total of 199 subjects were included: 48 in the ankylosis group and 151 in the synovitis group.

Results

The mean initial follow-up time was 5.2 and 7.2 months for the ankylosis and synovitis groups, respectively. The mean final follow-up time was 3.7 and 4.8 years, respectively. For initial follow-up, the ankylosis group reported 31% better, 56% unchanged, and 13% worse, whereas the synovitis group reported 69% better, 29% unchanged, and 2% worse (P < .001). For final follow-up, the ankylosis group reported 44% better, 41% unchanged, and 15% worse, whereas the synovitis group reported 78% better, 10% unchanged, and 12% worse (P < .001).

Conclusions

After TKA, arthroscopic surgery can reduce symptoms and improve satisfaction for patients with ankylosis or synovitis. Patient satisfaction is improved in a greater percentage of patients with synovitis compared with ankylosis.

Level of Evidence

Level III, retrospective, comparative study.