A method of treatment of knee hemosynovitis after arthroscopic meniscal resection

Aim. Optimization of the treatment of patients with knee hemosynovitis after arthroscopic meniscal resection in early postoperative period.

Methods. The results of treatment of 79 patients aged 18 to 60 years, who underwent arthroscopic meniscal resection complicated by knee hemosynovitis, were analyzed. Out of them, 38 patients underwent the treatment according to authors’ method (group 1) which included joint drainage with +5 °С isotonic solution of Sodium hydrocarbonate until the solution ran clear, and intraarticular administration of a cocktail of 5% Ascorbic acid solution for injections, 5% Sodium dimercaptopropansulfonate (unithiol) and 0.5% procaine (novocaine) in a ratio 1:1:1. 41 patients (group 2) received traditional treatment - only tapping and intraarticular administration of 3 ml of 0.5% procaine (novocaine). To assess the efficacy of treatment, severity of edema and pain syndrome, results of MRI on days 3 and 7 after arthroscopy, hydrogen ion concentration, relative density, lipid hydroperoxide level, total SH-groups, cytosis and synovial cytogram of hemosynovial fluid were measured, as well as the number of punctures, hospital stay and survey results of 45 patients.

Results. Surgical intervention was found to lead to inflammation, decreased hydrogen ion concentration, increased lipid peroxidation and decreased thiol antioxidants concentration. The severity of these changes correlates with severity of clinical manifistations. In the early postoperative period inflammatory processes develop in the knee, which clinically manifest as hemosynovitis, occurrence of which after arthroscopic meniscal resection is 16%.

Conclusion. The developed method of the treatment of postoperative hemosynovitis leads to faster decrease of severity of lipid peroxidation, pain syndrome and inflammatory reaction as opposed to traditional treatment.