Synovectomy
Synovectomy is an operation performed to remove partial or all the synovial membrane of a joint. The procedure is either by classic arthrotomy or arthroscopy.
Arthroscopic synovectomy has many advantages over open synovectomy: including minimal invasive surgery, short hospital stay, diminution of postoperative joint stiffness, and better complete synovectomy.
Arthroscopy allows for a more accurate diagnosis and facilitates the ability to ascertain small, localized areas of synovitis.
In an arthroscopic procedure, the excision can be restricted to the areas of involvement in the localized form. When total synovectomy is indicated, an experienced arthroscopist can more adequately perform a total synovectomy than an open Arthroscopy.
Surgical Technique
Five or six arthroscopic portals are used in a complete arthroscopic synovectomy lateral and medial suprapatellar, anteromedial, anterolateral, posterolateral posteromedial.
A 5mm diameter arthroscope is used with a motorized shaver with a 5.5-mm diameter resector is inserted through these portals.
This is a very demanding technique requiring to respect a step by step technique not to under resect synovial membrane an to prevent any damage to vascular or nervous elements around the joint specialy at the posterior compartments.
Synovectomy is usually performed in the following sequence
1- Intercondylar notch (to make a gateway for posterior compartments).
2- Posterolateral compartment.
3- Posteromedial compartment.
4- Medial compartment.
5- Lateral compartment.
6- Suprapatellar compartment.
7- Retropatellar compartment.
At the anterior compartments, we examine the undersurface of each meniscus with great care. In the case of popliteal cysts communicating with the joint, it is appropriate to proceed with combined arthroscopic treatment or to remove the popliteal cyst through an open posterior approach after the arthroscopic synovectomy.
After completing the synovectomy and releasing the tourniquet, bleeding control is achieved with electrocautery. A compressive dressing is applied.
We are here to help you Get relief from your pain
Get reed of from various body pain from our experienced doctor.