Summary

Gouty arthritis is an inflammatory joint disease caused by uric acid crystals in the inner and outer parts of the joint. Conservative treatment is suitable for most patients, but there are still some limitations in the diagnosis and treatment of atypical manifestations and sustained joint destruction. With the gradual maturation and extensive development of arthroscopic surgery, it has created the conditions for the early diagnosis of gouty arthritis.

Abstract

Purpose:To investigate the methods, clinical efficacy and advantages of arthroscopic surgery for the treatment of recurrent gouty arthritis of the knee joint.
Methods:Retrospective analysis of 28 cases of recurrent gouty arthritis of knee joint treated with arthroscopic minimally invasive surgery since 2010. Using arthroscopic debridment，underwent local synovectomy，and the urate crystals on menisci，anterior and posterior cruciate ligaments．and articular cartilage surface were scraped and simultaneous cavity irrigation. Postoperative anti-inflammatory and analgesic, dietary control and uric acid lowering therapy, early functional exercise. VAS pain score and Lysholm joint function score were recorded.
Results:28 cases were healed without infection．Postoperative knee swelling and pain disappeared 5—8 days after operation，7-14 days after discharge, and the knee function were improved to varying degrees in 2—3 weeks, of which 6 cases of acute gout attack. Follow up of 3 months to 1 years,according to the assessment by knee function Lysholm scoring，the scores(90.6±2.6)six month after the operation were greatly increased compared with preoperative scores(46.8±3.3)，with a statistically significant difference(P<0．05)．
Conclusion:Arthroscopic surgery for the treatment of recurrent gouty arthritis of the knee joint can effectively prevent various intraarticular structures from further erosive damage，thus restraining the development of joint deformity and dysfunction．Arthroscopy is the reliable choice for the treatment of chronic gouty arthritis．Advantages of this technique are minimal invasive，simple procedure，less time for operation and hospitalization with early rehabilitation，and all the combined lesion can be treated at the same time．