Under what circumstances is synovectomy (removal of the synovium) required?

May 10, 2023 Source: Cainiu Health

Dr. Lin Yunfei

Introduction

Situations requiring synovectomy include arthritis, synovitis, and joint replacement surgery. In severe arthritis, the synovium becomes excessively proliferative and releases fluid, leading to joint pain; removing the synovium helps alleviate symptoms. When synovitis cannot be managed with medication or is severe, synovectomy can relieve symptoms and control inflammation. During joint replacement surgery, synovectomy facilitates prosthetic implantation and reduces bleeding.

Conditions that may require synovectomy include arthritis, synovitis, and joint replacement surgery. The details are as follows:

1. Arthritis

When symptoms of arthritis are severe, the synovium may become excessively proliferative and release large amounts of fluid, causing joint pain and swelling. In such cases, removing the synovium under the care of a qualified physician can help alleviate symptoms.

2. Synovitis

If medication fails to treat the condition or if the disease is particularly severe, synovectomy performed by a specialist may be necessary to relieve symptoms and control inflammation.

3. Joint Replacement Surgery

Patients undergoing joint replacement surgery often require removal of the synovium, which facilitates easier implant placement and helps reduce blood loss.

In addition, synovectomy may also be needed in cases of joint tuberculosis, synovial tumors, or synovial sarcoma to relieve symptoms. It is recommended to undergo a thorough evaluation at a hospital and receive treatment under the guidance of a physician.

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Which acupuncture points should be selected for treating synovitis?

For synovitis, acupuncture typically targets the following acupoints: Futu (ST32), Zusanli (ST36), Sanyinjiao (SP6), and Xuehai (SP10). In mild cases of synovitis, the primary symptom is joint pain; joint swelling is generally not prominent, though a small number of patients may experience slight swelling and crepitus (a squeaking or grating sound) during walking. In severe cases, patients present with marked joint swelling and pain.

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Is electrotherapy effective for treating synovitis?

Electrotherapy is effective for treating synovitis. After developing synovitis, patients often experience relatively good outcomes with electrotherapy; however, electrotherapy constitutes only a small component of the overall treatment plan for synovitis. Relying solely on electrotherapy is insufficient—complementary therapeutic approaches are essential. As synovitis commonly affects joints such as the knee and hip, joint immobilization—i.e., minimizing joint stress—is mandatory during the acute phase.

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How long does it take to recover from synovectomy?

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Where is the synovial bursa located?

A synovial bursa is a fibrous sac containing a small amount of mucoid fluid that reduces friction between tissues. Normally, the synovial membrane appears pale red, smooth, and shiny, and is primarily composed of connective tissue. It is mainly located between the skin, muscles, and tendons in the human body, where it enhances lubrication, promotes flexibility of movement, and helps reduce tissue damage.