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Author Topic: How quickly to do Synovectomy for Arthritis Symptoms  (Read 561 times)

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Offline greatjava

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How quickly to do Synovectomy for Arthritis Symptoms
« on: February 14, 2012, 05:27:05 PM »
Scanned quite a few topics and didn't see anything relevant to my issue but certainly a lot of expertise here.

I have psoriatic arthritis, on and off for a decade. I'm 43. I've been taking methotrexate for 4 years and has helped greatly with lots of tenosynovitis problems in fingers and wrist. Also has helped with general joint inflammation. Very few big joint problems, all small joints.

6 months ago my knee started "squeking" and had MRI. It showed Patellofemoral syndrome and knee doc suggested exercises. Potential meniscus tear but not verifiable without scope. I had NO swelling or pain.

4 weeks ago knee swelled up "overnight" and very stiff and hard to work. No real pain for the most part. Arthritis doc got xray, showed soft tissue swelling behind knee cap. put me on medrol dosepack to get me by until I saw knee doc. Totally helped problem while I was on it.

Last week back to Knee Doc, he said he thinks we should do arthroscopic to fix knee cap issue above, synovectomy to get rid of inflamed issue, and examine potential tear/repair. I've not increased my methotrexate yet or done a cortisone shot. Some days the knee feels "fine" and can go up down stairs - just swollen. Other days it's pretty stiff and can't walk for long periods.

So my question for anyone with background or experience is should I be looking at increasing DMARD and cortisone shot first? Is the surgeon rushing to surgery? I've read typically synovectomy is typically done only after 6 months of other treatments are not fixing the problem.

I don't have a problem doing the surgery, but the surgeon seems to think the mechanical issues of knee cap are not the cause unless the joint has some cartilage broken off in it. What I've read is a cortisone shot is typically next to try to resolve issue but knee doc thinks it will just come back because the synovium is so messed up.

Any ideas or suggestions of things to ask would be helpful, thanks.