Arthroscopic Synovectomy and Lysis of Adhesions (With or Without MUA)

Arthroscopic synovectomy of the knee and lysis of adhesions, with or without the addition of manipulation under anesthesia (MUA), are two similar surgical techniques used to treat a number of orthopedic surgical pathologies. Arthroscopic lysis or adhesions has been described as an effective intervention for patients that experience arthrofibrosis of the knee, most often following a traumatic injury or surgical procedure. The goal of the surgery is to arthroscopically remove the intra-articular scar tissue, thus allowing the patient to regain their lost range of motion, whether in knee flexion, extension, or both. Similarly, patients that present with recurrent effusions secondary to a synovial pathology benefit from arthroscopic synovectomy. This procedure is most often performed in p atients with rheumatoid arthritis (RA) with symptoms recalcitrant to nonoperative systemic therapy. Additionally, patients with pigmented villonodular synovitis (PVNS), hemophilic synovitis, synovial chondromatosis, and synovial lipomatosis have been shown to benefit from arthroscopic synovectomy. Each of these surgeries are similar, in that they involve a challenging diagnosis as well as a surgery requiring advanced arthroscopic skills as well as knowledge of multiple portals that can aid in accessing all locations in the knee.