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Holmium:YAG laser effective for arthroscopic synovectomy in some RA patients

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Last Updated: 2001-07-30 16:41:45 EDT (Reuters Health)

WESTPORT, CT (Reuters Health) – Arthroscopic synovectomy performed with a holmium:YAG laser appears to be effective in treating knees and ankles in the early stage of rheumatoid arthritis (RA), according to a report by Japanese researchers.

Dr. Toshitaka Takagi and colleagues from Yokohama City University School of Medicine performed arthroscopic synovectomy in 23 joints in 17 women. They report data from an average followup of 24.4 months in the July issue of The Journal of Rheumatology.

In seven of eight knees graded 1 or 2 on the Larsen Classification Grade (7 patients), pain and swelling decreased during followup, Dr. Takagi's team reports. Range of motion improved in five knees and remained unchanged in the others. C-reactive protein levels were reduced in six of the seven patients, and levels of rheumatoid factor were reduced in five.

In three of the seven knees graded 3 at the time of the procedure (5 patients), Dr. Takagi's group found that pain and swelling increased during followup, and range of motion decreased in three knees. C-reactive protein levels increased in two of the five patients and rheumatoid factor increased in all five.

In the eight ankles treated (patients), the researchers found that pain and swelling decreased and range of motion increased, with no significant changes in levels of C-reactive protein or rheumatoid factor in any patient.

Dr. Takagi and colleagues believe that using the holmium:YAG laser to perform arthroscopic synovectomy at the early stage of RA "could serve as a alternative to disease-modifying antirheumatic drug therapy."

Use of the holmium:YAG laser under arthroscopic control "is the current state of the art in synovectomy techniques, and in my opinion is much more efficient than any previous open operative or radiochemical procedure," Dr. Robert W. Jackson from Baylor University Medical Center, in Dallas, comments in a journal editorial.

J Rheumatol 2001;28:1474-1475,1518-1522.

-Westport Newsroom 203 319 2700

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