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Abstract: The knee joint is one of the most important structures of the human body, in which the synovial membrane secretes synovial fluid and nourishes joint cartilage and other tissues. This patient was diagnosed with synovitis of the knee joint due to strain on the knee joint caused by years of participation in heavy physical labor, which led to inflammation of the synovial membrane of the knee joint and resulted in significant functional limitations of the joint and affected daily life. The patient’s prognosis is good, with significant relief of pain and restoration of knee movement through surgical treatment and rehabilitation.
Basic information】Male, 50 years old
Disease Type】Knee Synovitis
Hospital】Harbin First Hospital
Date of consultation】May, 2021
Treatment plan】Surgical treatment (arthroscopic synovectomy) + rehabilitation exercises
Treatment Period】7 days of inpatient treatment, 3 and 6 months of outpatient follow up
Results] Pain relief and recovery of knee movement
I. Initial consultation
The patient, 50 years old, was mainly engaged in heavy manual labor in his daily work. He had long-term excessive weight-bearing on his knee joint, which led to inflammation of the synovial membrane and a large amount of joint fluid, resulting in painful swelling and restricted movement of the joint, preventing him from walking with normal weight. The patient was diagnosed with synovitis of the knee by MRI of the knee joint. Since the patient’s knee synovitis was not at an early stage, conservative treatment, such as heat application and rest, was ineffective and slow, and could not meet the patient’s daily work needs. Therefore, an arthroscopic synovectomy was considered to remove the inflamed synovium and restore the joint function as soon as possible. After understanding the extent of his lesion, the patient agreed to be admitted to the hospital for surgical treatment.
II. Treatment history
After consideration, the patient was treated by arthroscopic synovectomy of the knee joint. During the surgical treatment, it was observed through the arthroscope that the patient’s knee synovium had inflammatory hyperplasia and the secreted inflammatory synovial fluid had caused some damage to the articular cartilage, but the degree of damage was relatively mild. The inflammatory synovium was completely removed, the knee was repeatedly flushed, and the surgical incision was closed after confirming that the range of motion of the joint had been restored. Postoperatively, cotton pads with bandages were given to prevent bleeding from the surgical incision. After the anesthetic effect wore off, the patient was allowed to move appropriately, gradually shifting from bedside activities to off-bed activities, and gradually began active contraction-diastole training of the quadriceps muscle to promote swelling and pain relief, as well as to promote the elimination of joint effusion.
III. Treatment effect
After a series of surgical treatment and rehabilitation training, the clinical symptoms of the patient’s knee joint were all significantly relieved, and he could gradually move out of bed with weight. After 7 days of hospitalization, the patient recovered well from the surgical incision, with no blood or fluid leakage and no other uncomfortable symptoms, and was discharged from the hospital for recuperation. After outpatient review and follow-up, the patient was found to be able to resume moderate physical activity at 3 months postoperatively, but participation in heavy physical labor still induced knee pain. At 6 months postoperatively, the patient’s knee joint no longer showed symptoms such as pain and mobility disorders when performing weight-bearing activities at work, and the prognosis was good.
IV. Precautions
We are glad that the patient’s condition improved significantly after active surgical treatment and postoperative rehabilitation exercises, and that the patient’s recovery was satisfactory in the later stage. However, since the patient was not completely cured at the time of discharge, the following points still need to be noted.
1, the patient can be discharged from the hospital to intermittent hot compress treatment of the knee joint, through hot compress to accelerate the synovial blood circulation of the knee joint, promote the absorption of joint effusion, improve the synovial inflammation of the knee joint.
2. Before the complete disappearance of joint symptoms, patients should pay attention to the protection of the knee joint, do not overload the knee joint, even daily walking needs to control the time and walking distance to avoid prolonged synovial repair of the knee joint and long-term limitation of joint function.
3. if patients suddenly develop clinical manifestations such as joint swelling, pain and fever while at rest, they should be promptly followed up at the orthopaedic clinic to clarify whether there is joint infection or recurrence of synovial inflammation, etc.
4. After discharge from the hospital, patients should strengthen the muscle exercises around the knee joint, which can speed up the recovery and have a better effect on preventing the recurrence of synovitis of the knee joint.
V. Personal insight
The human body has a very fine structure, and the synovial membrane of the knee can secrete synovial fluid, which nourishes the cartilage and meniscus of the joint, and once synovial inflammation occurs, it can cause clinical symptoms such as joint pain. Prolonged weight bearing and overexertion often cause damage to the knee joint, resulting in synovial inflammation, and the synovitis of the knee joint in this patient was mainly related to overexertion leading to strain.
This also warns us that in order to prevent synovitis in the knee joint, we should try to reduce excessive weight bearing on the knee joint and protect the knee joint function. At the same time, we should pay attention to keeping the knee joint warm and enhancing its stability in our daily life.