When joint pain becomes chronic, many people turn to doctors for pain relief. One part of the tissues that surround the joints is called the synovium. This is a thin portion of tissue that covers joints and is like a membrane. It lubricates the joint and helps make movement easier and more fluid. When the synovium becomes inflamed repeatedly, sometimes removing it can help the patient with pain management. This is known as a synovectomy. Synovectomy is most commonly done for the hand and fingers, which are known for being affected by arthritis and other problems.
Common Causes for Joint Synovectomy
As people age, many of them experience joint pain that comes with arthritis. Rheumatoid arthritis is extremely common and can be very painful. Rheumatoid arthritis can cause pain in the joints, but more specifically in the tissues surrounding them. These tissues become inflamed and swollen over time as they degenerate. The tissues surrounding the joints can become inflamed through other conditions like bursitis, which can happen at any age. Some common symptoms can be that the hands or finger joints are aching, seem warm to the touch, or feel stiff and sore. The synovium can also become thicker and less malleable over time and produce too much synovial fluid, which can actually eat away at the cartilage of the affected joint. A doctor may recommend synovectomy as a result of these symptoms.
Basics of the Joint Synovectomy Procedure
This surgery can differ greatly depending on the joint where the operation is performed. When the operation is performed on the hand and fingers, the hand is sterilized and cleaned, then placed in a way that will allow access to that joint. Hand and wrist surgeries are generally categorized as less invasive. The patient is placed under anesthetic or a numbing agent is applied. When synovectomy is performed on the fingers, the incision is usually made directly over the joint, but for larger joints most surgeons opt to use several small incisions. Once the incision is made, the inflamed synovium is quickly removed. The surgeon will then repair any damaged ligaments or other tissues around the joint with stitches. This is a key part of the surgery, as deterioration may have happened over time. Then, the incision site is closed and bandaged. If the operation was performed on a finger, the hand is splinted so that the wound will not open up. The patient should be able to return home directly after the surgery.
Recovery Time and Healing
After the surgery has been completed, some patients do experience nerve pain or numbness in the area, but it tends to go away as the incision heals. Postoperative stiffness is a common side effect of the surgery. Most doctors wait only a few days for the incision site to heal before prescribing physical therapy. Once it has healed completely, the physical therapy should continue for several weeks. Complications after the surgery are rare, and most people experience fast healing and return to normal function. The patient usually would continue taking medication that would reduce inflammation in the joints, which would likely be more effective after the surgery.
Long Term Outcomes
For most patients, this surgery is a great way to relieve pain from arthritis or other joint problems. This usually leads to less swelling of the joints and more mobility. Synovectomy is currently the only procedure that has shown long term pain relief and healing that improves a patient’s joint pain without limiting their mobility. Most patients want to be able to use their hands and wrists regularly, so this is a very promising surgery for many people with joint pain.