Abstract
Although there are numerous studies about routine histopathological analysis during
arthroplasty surgeries, most of them showed that new diagnoses have rarely been obtained
as a result. The aim of this study was to evaluate the efficacy of routine pathological
analyses of synovia resected during primary total knee arthroplasty in patients with
osteoarthritis and its relevance in the treatment process. Of the 47 included patients
who were followed up prospectively, 26 patients had clinical and histopathological
concordant diagnoses and 21 patients had discrepant diagnoses. Oxford knee score and
visual analogue score were performed for all the patients. Kallgren-Lawrence score
was used for radiological analyses. The Mann-Whitney U test was used to examine the
differences between the abnormally distributed variables. Mean age was 65.9 ± 4.3
years (range, 50–89 years) and mean follow-up time was 19 ± 7.8 months (range, 6–39
months). Grade IV gonarthrosis was found to be statistically lower in the discrepant
group (p = 0.046). The mean preoperative Oxford knee score was 16.8 ± 2.3 (range, 2–23) and
the mean postoperative Oxford knee score was 44.6 ± 1.8 (range, 27–48; p = 0.016). Postoperative Oxford knee scores and VAS were significantly increased in
both the concordant and discrepant groups (p = 0.026 and p = 0.035, p = 0.019 and p = 0.039, respectively). Resection and histopathologic analyses of the hypertrophied
and inflamed synovium encountered during primary arthroplasty procedure should be
performed. This examination not only could provide crucial information that may influence
the postoperative follow-up guidelines but also could help us to expand our knowledge
and awareness of rare diseases that might yield osteoarthritis. The level of evidence
for the study is level II.
Keywords
synovium - total knee arthroplasty - pathological analysis - lipoma arborescence
