Joint lavage and pseudogout

Joint lavage, although its efficacy is still under debate,1–6 seems to be effective, mostly, in the treatment of gonarthritis associated or not with chondrocalcinosis (CC).2,3,7 Paradoxically, acute pseudogout is a complication of this technique.8 Our study aimed at evaluating the incidence of pseudogout in 73 patients with gonarthritis, associated or not with CC, who underwent arthroscopic lavage (AL). Previous SectionNext Section METHODS AND RESULTS In this retrospective study we assessed the incidence of pseudogout attacks that occurred 24 hours after surgery in 73 consecutive patients with gonarthritis (52 women (71%), 21 men (29%)), who underwent AL of the knee at our hospital. All the patients had medium-severe symptomatic osteoarthritis, according to Kellgren and Lawrence’s classification (II-III-IV degrees),9 and were unresponsive to drugs (that is non-steroidal anti-inflammatory drugs, analgesics, disease modifying osteoarthritis drugs) and rehabilitative treatment. AL was carried out with an arthroscopic sheath 5.5 mm in diameter and 12 cm long, preceded by intra-articular carbocaine 2%. Twenty three patients had radiological or laboratory signs of CC, including x ray evidence of meniscal and cartilaginous opacities and/or birefringent positive intra- and extracellular calcium pyrophosphate crystals (CPPD) in the synovial fluid (group A). The remaining 50 patients had gonarthritis with no evidence of CC (group B) (table 1). They were followed up clinically 1 and 10 days after the AL.