Surgical Synovectomy Decreases Density of Sensory Nerve Fibers in Synovial Tissue of Non-Inflamed Controls and Rheumatoid Arthritis Patients

Ossyssek, B. and Anders, S. and Grifka, J. and Straub, R. H. (2011) Surgical Synovectomy Decreases Density of Sensory Nerve Fibers in Synovial Tissue of Non-Inflamed Controls and Rheumatoid Arthritis Patients. JOURNAL OF ORTHOPAEDIC RESEARCH, 29 (2). pp. 297-302. ISSN 0736-0266, 1554-527X

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Abstract

Surgical synovectomy is a technique to treat synovitis and pain in patients with rheumatoid arthritis (RA) resistant to DMARDs or therapy with biologics. Indication to synovectomy is subject to tight cooperation of orthopaedic surgeons and rheumatologists. It was thought that synovectomy leads to a reduction of sensory nerve fibers, called sensory denervation. Since sensory denervation after synovectomy has never been histologically tested, we aimed to investigate sensory and sympathetic innervation in synovial tissue before and after synovectomy. Eight non-inflamed control subjects and eight patients with RA were included in this study with a two-stage synovectomy approach (interval 40-50 days). Nerve fibers and cells in synovial tissue were detected and counted using immunofluorescence. Density of sympathetic nerve fibers did not change after synovectomy, whereas density of sensory nerve fibers decreased in all control subjects and seven of eight patients with RA. In parallel, the density of synovial cells increased after synovectomy in all control subjects and six of eight RA patients, which is indicative of a wound healing response. In one female RA patient, density of sensory nerve fibers increased and a very marked rise of cellular density was observed, too. This indicates that probably not all patients profit from surgical synovectomy. The majority of patients (94%) demonstrated sensory denervation after surgical synovectomy accompanied by a wound healing cell response. This study can help to explain the positive effects of surgical synovectomy which usually leads to pain reduction and improved mobility. 2010 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 29:297-302, 2011

Item Type: Article
Uncontrolled Keywords: SUBSTANCE-P; ARTHROSCOPIC SYNOVECTOMY; HUMAN-MONOCYTES; CELLS; RAT; INFLAMMATION; JOINT; OSTEOARTHRITIS; NEUROPEPTIDES; SENSITIZATION; rheumatoid arthritis; osteoarthritis; synovectomy; sensory nerve fibres; sympathetic nerve fibres; denervation
Subjects: 600 Technology > 610 Medical sciences Medicine
Divisions: Medicine > Lehrstuhl für Innere Medizin I
Medicine > Lehrstuhl für Orthopädie
Depositing User: Dr. Gernot Deinzer
Date Deposited: 26 Jun 2020 09:03
Last Modified: 26 Jun 2020 09:03
URI: https://pred.uni-regensburg.de/id/eprint/21321

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