Arthrotomy, with Synovectomy, Knee; Anterior OR Posterior

Name of the Procedure:

• Medical Terms: Arthrotomy, with Synovectomy, Knee; Anterior OR Posterior
• Common Name: Knee Joint Surgery with Synovial Membrane Removal

Summary

An arthrotomy with synovectomy of the knee involves surgically opening the knee joint to remove the synovial membrane, which is the lining of the joint. This procedure can be performed on either the anterior (front) or posterior (back) part of the knee.

Purpose

• Medical Condition: The procedure addresses chronic inflammation or disease of the synovial membrane, such as rheumatoid arthritis or synovitis.
• Goals: The primary goals are to relieve pain, reduce inflammation, and improve knee function. It can help restore mobility and prevent further joint damage.

Indications

• Conditions: Chronic synovitis, rheumatoid arthritis, persistent knee pain, and swelling not responding to conservative treatments.
• Patient Criteria: Patients with failed medical treatments for their condition and those suffering from significant pain and restricted movement.

Preparation

• Pre-Procedure Instructions: Patients may be asked to fast for 6-8 hours before the procedure. Adjustments to medications, especially blood thinners, will be advised by the doctor.
• Diagnostic Tests: Pre-surgical imaging studies such as MRI or X-ray, blood tests, and a full medical assessment to ensure patient stability for surgery.

Procedure Description

1. Anesthesia: General or regional anesthesia will be administered for pain management.
2. Incision: An incision is made either on the anterior or posterior part of the knee.
3. Exposure: The joint capsule is carefully opened to expose the synovial membrane.
4. Removal: The inflamed or diseased synovial tissue is excised.
5. Closure: The incision is closed with sutures or staples, and a sterile dressing is applied.

• Tools: Surgical instruments, arthroscope if minimally invasive approach is chosen.
• Technology: Imaging guidance may be used for precise tissue removal.

Duration

• Typical Duration: The procedure usually takes about 1 to 2 hours, depending on the extent of the synovectomy.

Setting

• Location: Performed in a hospital operating room or a specialized surgical center.

Personnel

• Healthcare Team: Orthopedic surgeon, surgical nurses, anesthesiologist, and possibly a surgical technologist.

Risks and Complications

• Common Risks: Infection, bleeding, and blood clots.
• Rare Complications: Nerve damage, stiffness, or recurrence of symptoms.

Benefits

• Expected Benefits: Reduction in pain, improved joint function, and decreased inflammation. Benefits can often be felt a few weeks after recovery.

Recovery

• Post-Procedure Care: Pain management with medications, physical therapy, and regular follow-up appointments.
• Recovery Time: Initial recovery may take a few weeks, with full recovery spanning several months. Patients should avoid heavy lifting and strenuous activities until cleared by their doctor.

Alternatives

• Other Options: Non-surgical treatments like medications, physical therapy, and joint injections.
• Pros and Cons: Alternatives might be less invasive but may not provide long-term relief as effectively as the surgical approach.

Patient Experience

• During Procedure: Patients will be under anesthesia and should not feel pain.
• After Procedure: Mild to moderate pain and swelling managed with medications, rest, and ice. Physical therapy will be conducted to regain mobility and strength.

Pain management and support measures will be provided to ensure comfort throughout the recovery period.