If not treated properly, rheumatoid arthritis (RA) of the wrist can cause loss of wrist function as well as gradual joint degradation. Local inflammation may benefit from arthroscopic synovectomy of the wrist. For a study, researchers sought to conduct a comprehensive assessment of functional outcomes and pain in patients with RA after arthroscopic synovectomy of the wrist. PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analysis) criteria were used for conducting the systematic review. MEDLINE, EMBASE, The Cochrane Library, Web of Science, and Google Scholar were searched for papers documenting pain or functional results in patients with RA following arthroscopic synovectomy of the wrist (CRD42021270846). The Methodological Index for Non-Randomized Studies was used to determine the risk of bias. Patient characteristics, pain levels, wrist function surveys, subsequent surgery, and complications were all collected for analysis.
A total of 153 arthroscopic synovectomies were included in 6 non-comparative cohort studies. The duration of the RA disease varied from 32 to 89 months, with radiographic progression ranging from mild to severe. The ratings for the Methodological Index for Non-Randomized Studies varied from 8 to 10 out of a possible 16. The average period of follow-up was 21 to 95 months. The pooled mean visual analog scale pain score improved (from 7.7 to 2.2, P<0.05), as did the pooled mean Modified Mayo Wrist Score (from 43.3 to 70.4, P<0.05) and the Disability of the Arm, Shoulder, and Hand (from 67.5 to 36.5, P<0.05). There were 2 problems, and 5 patients needed further surgery.
There was minimal evidence that arthroscopic wrist synovectomy improved wrist function and discomfort in patients with RA with few consequences. It might be regarded as a therapy option at clinics with arthroscopic competence.
