Evaluating functional recovery post-total knee replacement, a WOMAC based comparison of synovectomy versus non-synovectomy approaches in a tertiary care hospital in South India

Background: Synovectomy is commonly performed during total knee arthroplasty (TKA) for patients with osteoarthritis (OA) and inflammatory arthritis to address synovial inflammation. However, its impact on long-term functional outcomes remains unclear. Objective of this study was to evaluate the effect of synovectomy during TKA on postoperative pain, stiffness, and functional outcomes in patients with OA and inflammatory arthritis. Methods: A hospital-based retrospective cohort study was conducted with 86 patients who underwent TKA one year prior (43 with synovectomy, 43 without). The Western Ontario and McMaster osteoarthritis index (WOMAC) was used to assess pain, stiffness, and physical function at follow-up. Results: The mean age of patients was 65.4 years. No significant differences were found in pain (p=0.638) and stiffness (p=0.647) between the two groups. However, physical function was significantly better in the group without synovectomy (p=0.004), with significantly fewer difficulties in activities such as standing, bending, and getting in/out of bed (p<0.05). The mean total WOMAC score was significantly lower in the group without synovectomy (p=0.045). Conclusions: Synovectomy during TKA had no impact on postoperative pain or stiffness and was associated with poorer functional outcomes compared to TKA without synovectomy. These findings suggest that synovectomy may not offer additional benefits for patients with OA and inflammatory arthritis. Further research with larger samples is recommended to better understand its role in TKA.