Background/Purpose
The utility of synovial biopsy has been confirmed as an important research tool in increasing our understanding of the pathogenesis of RA, evaluating new treatments and identifying potential therapeutic targets (1, 2). More rheumatology units are introducing arthroscopy as part of their research programs,(3). In 2004, we published data showing that complication rates are very low (4), however it is critically important to continue to monitor safety and audit our outcomes.
All procedures are performed under local anaesthesia in a state of the art, built-for-purpose facility.
We collected and analysed the experience reported by patients following arthroscopy in our unit, examining parameters such as overall tolerability, pain, time out of work post-arthroscopy and complications.
Methods
Consecutive patients returning to the arthroscopy programme since July 2013 completed a questionnaire including 16 questions, three visual analogue scales (VAS 0mm-100mm), as well as binary questions.
Results
136 (47 male) respondents are included, age 20-82 years (mean 53.76, SD 13.86).
91.2% (124/136) of patients felt they had received adequate information before the procedure. 84.6% (115/136) reported that the procedure matched their expectations. The main concern before the arthroscopy was potential pain during the procedure cited by 78.7% (107/136).
The mean VAS for pain during the procedure was 50mm (SD 34.6); in the first 48 hours after the procedure 31mm (SD 28.2); and 15mm (SD 24.1) in the month following the procedure. There was no correlation between diagnosis, age or sex to VAS.
64.0% (73/114) were out of work for less than 2 days, 29.8% (34/114), and 6.1% (7/114). The remainder of patients left this field blank. No significant complications were reported. 66.9% (91/136) felt improvement in their knee symptoms following arthroscopy.
Conclusion
Knee arthroscopy remains a safe and well tolerated research procedure. The procedure is well tolerated under local anaesthesia, and many patients experience an improvement in their knee symptoms. Patients are out of work for very short periods following arthroscopy and no significant complications were reported.
References
1. Gerlag DM, Tak PP. Novel approaches for the treatment of rheumatoid arthritis: lessons from the evaluation of synovial biomarkers in clinical trials. Best Practice & Research Clinical Rheumatology. 2008;22(2):311-23.
2. Kraan MC, Reece RJ, et al. Modulation of inflammation and metalloproteinase expression in synovial tissue by leflunomide and methotrexate in patients with active rheumatoid arthritis: Findings in a prospective, randomized, double‐blind, parallel‐design clinical trial in thirty‐nine patients at two centers. Arthritis & Rheumatism. 2000;43(8):1820-30.
3. Harty LC, Gerlag DM, et al. Synovial tissue analysis for the discovery of diagnostic and prognostic biomarkers in patients with early arthritis. The Journal of Rheumatology. 2011;38(9):2068-72.
4. Kane D, Veale D,et al. Survey of arthroscopy performed by rheumatologists. Rheumatology. 2002;41(2):210-5.
Disclosure:
C. Orr,
None;
P. MacMullan,
None;
P. Gallagher,
None;
M. Murray,
None;
M. O’Neill,
None;
D. J. Veale,
Abbvie,
2,
MSD,
2,
Pfizer Inc,
2,
Roche ,
2,
Pfizer ,
5,
Roche ,
5,
Abbott,
8,
MSD,
8,
Pfizer,
8,
Roche ,
8.
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