ABS0906 EARLY CORTICOSTEROID INJECTIONS IN HIGH-RISK POST-ARTHROSCOPIC SYNOVITIS: SAFETY, EFFECTIVENESS, AND IMPACT ON QUALITY OF LIFE

<h2>Abstract</h2><h3>Background:</h3> Knee synovitis is a common complication following arthroscopic surgery, often resulting in swelling, pain, and functional limitations. If left untreated, synovitis can progress to chronic inflammation, delaying recovery and potentially accelerating the progression of osteoarthritis (OA). Early intra-articular (IA) corticosteroid injections may serve as an effective intervention to prevent this progression, though the optimal timing and the safety and efficacy of this approach, including in quality of life, still require further clarification. <h3>Objectives:</h3> To compare the safety, clinical effectiveness, and functional outcomes, including quality of life, of early IA corticosteroid injections versus standard postoperative treatment in patients at high risk for persistent post-arthroscopic synovitis. <h3>Methods:</h3> This prospective, randomized trial included 174 patients (43.7% men, 56.3% women), with a mean age of 56.2 ± 1.67 years. The majority of patients (92.5%) had OA stage 1-2. A previously established prognostic model identified those at high risk for prolonged synovitis following arthroscopy, among which patients with persistent synovitis at 3 weeks post-surgery were randomized into two groups: the main group, receiving an early IA corticosteroid injection on days 21–25 post-surgery, and the comparison group, receiving standard treatment. Effectiveness was evaluated at 3 weeks, 3 months, and 6 months using the KOOS and SF-36 scales. Data analysis was performed using SPSS software. <h3>Results:</h3> Of 174 patients, 26 (14.9%) were classified as high risk for persistent synovitis. At 3 weeks post-surgery, 24 patients (92.3%) still had persistent synovitis. Baseline KOOS was 49.4 ± 1.3, SF-36 physical component summary (PCS) score – 37.6 ± 1.2, and mental component summary (MCS) score – 37.9 ± 1.7. No infections or serious adverse events were reported after IA corticosteroid injections. The duration of synovitis was significantly shorter in the primary group (1.0 [1.0; 1.75] months) compared to the comparison group (2.5 [1.0; 3.75] months, p=0.029). At 3 months, the primary group showed significant improvements in functional outcomes, with KOOS scores increasing from 47.6 ± 2.25 to 85.25 ± 1.95 (+40.0 [35.3; 43.0], p < 0.001), compared to an increase of +17.5 [8.0; 34.25] in the comparison group (p = 0.002). Physical health (PCS) scores also improved in both groups, with the primary group showing a greater improvement (47.5 ± 1.2 vs. 41.4 ± 1.3, p=0.003). By 6 months, the differences between the groups diminished, with both groups achieving similar long-term outcomes. <h3>Conclusion:</h3> Early IA corticosteroid injections in patients at high risk for persistent post-arthroscopic synovitis were safe and led to a significant reduction in synovitis duration, as well as improvements in joint function and quality of life at 3 months, compared to standard treatment. By 6 months, the differences between the groups leveled off, yielding comparable long-term results. <h3>REFERENCES:</h3> [1] Nuriakhmetov A.N., Nuriakhmetova T.Yu., Akhtyamov I.F. Kazan State Medical University, Ministry of Health of the Russian Federation. Method for predicting the risk of long-term postoperative synovitis of the knee joint. Patent No. RU2822328 C1. Application No. 2024112214. Claimed 06.05.24; Published 04.07.24, Bulletin No. 19. (In Russ.) <h3>Acknowledgements:</h3> <b>NIL</b>. <h3>Disclosure of Interests:</h3> <b>None declared</b>. © The Authors 2025. This abstract is an open access article published in Annals of Rheumatic Diseases under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). Neither EULAR nor the publisher make any representation as to the accuracy of the content. The authors are solely responsible for the content in their abstract including accuracy of the facts, statements, results, conclusion, citing resources etc.

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