Arthroscopic synovectomy for the management of shoulder arthropathy in chronic renal dialysis patients.

Overview

We present the clinical results of 7 hemodialysis patients after arthroscopic shoulder synovectomy (1 bilateral) for night pain and decreased range of motion. There was no evidence of infection in any of the shoulders at the time of surgery. The results of histologic analysis of synovial tissue were negative for crystals in all of the patients. Tissue from 1 of 7 patients was positive for amyloid. All 7 patients had significant pain relief at a mean of 2.3 months postoperatively. At a mean of 5.5 years postoperatively, the mean L'Insalata score was 68.8 +/- 12.2 points. Five of six patients rated their overall satisfaction with the procedure as good or excellent. Forward flexion and external rotation had improved by a mean of 40 degrees and 20 degrees, respectively. The mean American Shoulder and Elbow Surgeons score was 64.5 +/- 13.1 points. We believe that arthroscopic synovectomy is an effective treatment for hemodialysis patients who have shoulder pain, particularly night pain that is not caused by infection and fails to respond to conservative management.