Abstract
The objective of this study is to assess pain, function, and morbidity in patients
undergoing synovectomy during primary total knee arthroplasty (TKA) for osteoarthritis
(OA). A meta-analysis, which included randomized controlled trials comparing TKA with
and without synovectomy for OA, was completed. The primary outcome was postoperative
knee pain. Secondary outcomes included performance, perioperative complications, validated
functional scores, operation length, and hospitalization length. A literature search
produced 487 unique references, of which 3 randomized controlled trials were selected
for inclusion. A total of 304 patients (354 knees) were included, with an average
age of 67 years. Follow-up intervals between studies ranged from 26 weeks to 12 months.
Included studies were of moderate- to high-quality evidence with low risk of bias.
There was no significant difference between the two groups in regard to postoperative
pain, Knee Society Score, or postoperative range of motion. Postoperative blood loss
was significantly lower in synovium-retaining TKA group (MD = 99.41 mL; 95% confidence
interval, 45.08–153.75). Based on these results, there is currently no evidence to
support the use of synovectomy in TKA for primary OA, as it provides no clinical benefit
and increases postoperative blood loss.
Keywords
blood loss - total knee arthroplasty - synovectomy - osteoarthritis
