Rheumatoid arthritis (RA) is a chronic systemic inflammatory autoimmune disease that affects approximately 1% of the global population. The lesions mainly exist in synovial tissue, leading to synovitis and further bone destruction, such as erosion or cartilage damage. Once affected, the elbow joint, as the central axis joint of the upper limb, will seriously affect the function of the upper limb, thereby affecting daily life. In the early stages of rheumatoid arthritis, when anti-rheumatoid drugs cannot control pain and inflammation, incision synovectomy was previously used in patients with elbow rheumatoid arthritis to alleviate pain and inflammation. However, it still presents higher postoperative complications, such as wound non-healing, infection, and joint stiffness. The therapeutic effect is significant after arthroscopic synovectomy of the rheumatoid elbow joint, especially in pain relief. Arthroscopic synovectomy has less trauma than open synovectomy. Despite the potential risk of nerve damage, it has the advantages of minimal postoperative pain, low risk of stiffness, and early activity recovery. This group used synovectomy under elbow arthroscopy to treat 12 cases of Larsen 3-4 stage rheumatoid elbow arthritis. After a short-term follow-up, the therapeutic effect was good.

To investigate the short-term clinical efficacy of arthroscopic techniques to treat patients with Larsen stage 3-4 of elbow rheumatoid arthritis.

Arthroscopic treatment was performed on 12 patients with well-defined rheumatoid arthritis of the elbow joint. The preoperative imaging examination showed Larsen staging of 3-4 stages. During the surgery, elbow joint exploration and synovectomy were performed sequentially in the posterior, anterior, and brachioradial compartments to clean the elbow joint cavity. The average follow-up was 14.8 months, and the efficacy was evaluated using the elbow joint VAS pain score, elbow joint flexion and extension range of motion, and Mayo elbow joint function score before and after surgery.

The postoperative VAS pain score of the elbow joint decreased from (6.36 ± 0.92) points to (2.00 ± 0.77) points, and the flexion and extension range of motion increased from (63.28 ± 8.58) ° to (107.28 ± 4.60) °. The Mayo elbow joint function score increased from (49.94 ± 6.56) points before surgery to (77.27 ± 4.67) points, with 2 cases being excellent, 7 cases being good, and 3 cases being moderate. No patient experienced synovitis recurrence in the short term. All patients who underwent surgery have a very satisfactory subjective experience.

The short-term efficacy of arthroscopic treatment for Larsen stage 3-4 rheumatoid arthritis of the elbow is satisfactory. After careful synovial clearance during surgery, this technique can effectively reduce pain, restore elbow joint mobility, improve elbow joint function, and improve patient quality of life. The short-term efficacy is worthy of recognition.