Arthroscopic lavage treatment in rheumatoid arthritis of the knee

Objective. To assess the efficacy of outpatient arthroscopic lavage in rheumatoid arthritis (RA) of the knee. Methods. 9 patients with RA and active synovitis of at least one knee were selected. All patients were taking disease modifying antirheumatic drugs and nonsteroidal antiinflammatory drugs and had failed intraarticular corticosteroid injection of the knee. Using the 1.9 mm office arthroscope and strict sterile technique the affected knee was lavaged with at least 750 cc of normal saline. At the end of the procedure 40 mg triamcinolone acetonide was injected through the arthroscope. Assessment was done at baseline and 4, 8, and 12 weeks after the lavage using a visual analog scale for pain and 50 foot walk time. Results. 8 of the 9 patients showed marked improvement in their pain and walk time. This effect was maintained at least 12 weeks after the procedure. Conclusion. Office arthroscopic lavage treatment is beneficial in a selected group of patients. This procedure is simple and well tolerated without major complications, and may be an option when more conservative therapies have failed.