Preoperative synovitis in knee osteoarthritis is predictive for pain 1 year after total knee arthroplasty

Background: Knee osteoarthritis (KOA) was previously considered a degenerative joint disease due to wear and tear. After total Knee replacement (TKR) 13–38% of patients develop persistent post-operative pain. Emerging evidence has shown that the etiology of pain in KOA is multifaceted and may involve different structures including the synovial membrane, musculotendinous structures and neuronal tissue. Current preoperative assessment does not take these into account, thus the current study examines the role of preoperative synovitis on patient reported outcomes one-year post surgery. Material and methods: 40 patients with end-stage KOA answered the KOOS questionnaire prior to receiving total knee replacement surgery. During the procedure synovitis was scored systematically at six sites where synovial excision biopsies were obtained. Macro scoring was based on three parameters (hypertrophy, vascularity and synovitis) on a 0–4 point scale. Micro biopsies where also graded based on three parameters (synovial hyperplasia, inflammatory infiltration and activation of synovial stroma) but on a 0–3 point scale. Patients received a follow up KOOS questionnaire one-year post surgery. Results: 33 patients completed the KOOS questionnaire at follow-up. A high correlation between the micro mean, micro max, macro mean, and macro max was found. The micro mean was chosen as a proxy for the amount of synovitis. A multiple linear regression analysis, correcting for baseline values of BMI, age, smoking, point pressure thresholds (PPTs) and KOOS pain, showed that the synovitis measurement at baseline was significant for the change in KOOS pain with an effect of 22.22 (p = 0.0498). Hence, the more synovitis at baseline, the higher the follow-up KOOS Pain was compared to baseline KOOS Pain (an improvement). The standard deviation (SD) of the synovitis measure was 0.42, hence a change of 1 SD in synovitis gave an increase of 9 in KOOS Pain at follow-up compared to at baseline. Conclusions: These preliminary results indicate that the synovitis score attained during operation is positively correlated with improvement in KOOS-pain post operatively.

Object Details

• Location: Deutsche Nationalbibliothek Frankfurt am Main
• Extent: Online-Ressource
• Language: Englisch

References and Relationships

• Bibliographic citation: Preoperative synovitis in knee osteoarthritis is predictive for pain 1 year after total knee arthroplasty ; volume:16 ; number:1 ; year:2017 ; pages:184-184 ; extent:1 ; Scandinavian journal of pain ; 16, Heft 1 (2017), 184-184 (gesamt 1)

Contributors, Places and Time

• Creator: Vela, Jonathan ; Petersen, Kristian Kjær ; Arendt-Nielsen, Lars ; Meyer Andersen, Mikkel ; Simonsen, Ole

Further information

• DOI: 10.1016/j.sjpain.2017.04.056
• URN: urn:nbn:de:101:1-2024022714163979407260
• Rights: Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
• Last update: 14.08.2025, 10:58 AM CEST