The Impact of Total Synovectomy on Blood Loss and Knee Function. A Prospective Randomized Study

Mihnea A. Petre¹, Mihai E. Gherghe¹, Dragoș C. Cotor¹, Alexandru Luchian^{1, 2}, Liliana L. Preotescu^{3, 4}, Cristian Scheau^{5, 6,*}, Romică Cergan^{6, 7}

1 - Department of Orthopaedics, “Foișor” Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, Bucharest, Romania
2 - Department of Orthopaedics and Traumatology, The “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
3 - Department of Infectious Diseases I, Faculty of Medicine, The “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania
4 - “Prof. Dr. Matei Balș” National Institute for Infectious Diseases, Bucharest, Romania
5 - Department of Physiology, The "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
6 - Department of Radiology and Medical Imaging, “Foișor” Clinical Hospital of Orthopaedics, Traumatology and Osteoarticular TB, Bucharest, Romania
7 - Department of Anatomy, The “Carol Davila” University of Medicine and Pharmacy, Bucharest, Romania

Correspondence: Cristian Scheau, cristian.scheau@umfcd.ro

DOI: https://doi.org/10.55453/rjmm.2024.127.1.1

Received: July 28, 2023

Accepted: September 28, 2023

Abstract:

Synovial proliferation is a common intraoperative finding during total knee arthroplasty (TKA) and many studies have proposed synovectomy for the reduction of postoperative pain. We included 180 patients that were split into two groups, one which received a total synovectomy (TS) and the other with partial synovectomy (PS). We measured the amount of intra- and post-operative bleeding as well as perceived pain (using the Visual Analogue Scale) and knee function (using the Knee Society Knee Score) at 4 and 12 weeks. The blood loss during the surgical procedure was 367.77 ± 115.71 mL for TS, while the other group recorded 295.55 ± 106.17 mL (p < 0.05). Regarding postoperative bleeding, the TS group aspirated 533.77 ± 281.65 mL, which was significantly higher than the PS group (404.44 ± 211.55 mL, p < 0.05). No significant differences were recorded between the TS and PS groups regarding pain and knee function at 12 weeks. Total synovectomy demonstrated significantly higher blood loss and lower postoperative hemoglobin levels, even though knee function and pain level did not show improvements. We consider that the decision of performing synovectomy should rely on the clinical indication and, if conditions allow for it, a limited resection should be attempted.