Etiology and treatment of synovitis

  Synovitis is a multifaceted disease that develops mainly in the knee joint. It can easily cause temporary or long-term partial loss of labor force, which is harmful to both the patient and the society. Despite many effective treatments, many patients are still not cured.  Synovitis of the knee, in the elderly, is secondary to osteoarthritis of the knee, mainly due to mechanical biochemical irritation from cartilage degeneration and osteophytes, secondary to synovial edema, exudation and effusion of the knee joint.  In young adults it is mostly due to acute trauma and chronic injury. Acute traumatic injuries include: knee sprains, meniscal injuries, lateral collateral or cruciate ligament injuries, intra-articular effusion or sometimes blood accumulation, manifesting as acute traumatic synovitis of the knee. Sometimes it can also be caused by simple knee synovial injury, such as a mild trauma, or long-term chronic knee strain. Chronic synovitis of the knee joint can develop if the knee joint gradually becomes swollen and dysfunctional. In the elderly, it is mainly caused by mechanical biochemical irritation due to cartilage degeneration and osteophytes, which leads to synovial edema, exudation and fluid accumulation in the knee joint. Yang Xianchun, Department of Orthopedic Surgery, Chengdu Third People’s Hospital The swollen joint type is mainly swollen after excessive exercise, with pain of varying severity. In the non-swollen type, joint pain predominates and is often accompanied by mild swelling. Studies have confirmed that the two types are essentially the same, but differ only in the degree of synovial pathology. Researchers have found that after prolonged single-motion overload of the knee joint, the synovial tissue becomes congested and edematous, and the exudation of red and white blood cells and fibrin is positively correlated with the increase in intra-articular pressure and the decrease in oxygen partial pressure. Inflammation formation, thus, it is believed that the occurrence of traumatic synovitis after excessive exercise is not only related to the repetitive_strike of the joint surface and injury to the joint capsule, but also plays an important role in the development and regression of the disease process.  Synovitis is a joint lesion in which the synovial membrane is stimulated to produce inflammation, resulting in the imbalance of secretion to form effusion, which has long affected the normal life of patients, work, and brought a lot of trouble, some patients seek medical attention, recurrent attacks, pain, and even psychological overshadowing, synovitis is incurable, so can synovitis be completely cured, we believe that first of all, we should avoid causing trauma or strain The first thing you should do is avoid trauma or strain, and reduce weight-bearing and flexion/extension activities in the knee. Exercising the quadriceps is an important and effective therapeutic measure. Straight leg elevation promotes blood circulation and facilitates absorption of joint effusion, and mild knee synovitis generally does not require bed rest and can be walked for short distances.  Secondly, if there is a large amount of joint fluid and tension, joint puncture can be performed to completely remove the fluid and blood and inject sodium hyaluronate, which is the main component of synovial fluid, into the joint cavity. Studies have shown that various pathological changes in arthritis are closely related to its reduction and altered physicochemical properties. Sodium hyaluronate injection has the following effects: covering the surface of joint cartilage, which can protect joint cartilage and prevent or delay further degeneration; protecting joint synovial membrane and removing pain-causing substances, which has a significant effect on reducing pain; improving the contracture of joints and increasing the mobility of joints; improving the synovial fluid of degenerated joints.  Thirdly, some oral medications have the same mechanism of action as topical medications, and there are few medications that can be used for effective treatment of synovial lesions. Patients should pay attention to the selection of drugs, carefully check the drug’s function, such as the approval of the pain, swelling, fluid caused by synovitis, etc., it means that the drug only has anti-inflammatory effect to relieve symptoms. If patients want to achieve good results, they should take oral and external treatment at the same time, and they should adhere to the treatment and not stop taking the medication when the symptoms disappear. However, we should pay attention to the side effects of oral medications, many oral medications are harmful to the liver, gallbladder, spleen, kidneys, and it is best to treat with topical medications. Fourth, traditional Chinese medicine is an integral part of traditional medicine, profound, long history, is the national essence of China, thousands of years do not know how many difficult and complicated diseases cured, has been the national pride. The traditional theory of topical Chinese medicine for synovitis treatment is that “wind, cold, and dampness paralyze the meridians, causing them to be blocked, and if they are not blocked, they are painful”, so topical Chinese medicine treatment is aimed at dispelling wind and cold, relieving spasm and clearing the channels, and activating blood and silt. The Huang family powder pack is a topical Chinese medicine, following the principle of Chinese medicine is not pain, easy to use, non-allergic, thorough treatment; Huang family powder pack can achieve the effect of dredging the meridians, reduce swelling and pain, can completely cure the synovitis.