ObjectiveTo investigate the clinical effect of minimally invasive needle-knife endoscopy combined with disease-modifying antirheumatic drugs (DMARDs) therapy on patients with refractory rheumatoid arthritis (RRA), and its influence on levels of C-C motif chemokine ligand 19 (CCL19), C-X-C motif chemokine ligand 12 (CXCL12), and receptor activator of nuclear factor κB ligand (RANKL) in knee joint fluid. MethodsA total of 60 RRA patients were randomly divided into control group (n=30) or observation group (n=30). The control group received DMARDs for treatment, based on which the observation group received minimally invasive needle-knife endoscopy for treatment. The post-treatment efficacy, and pre- and post-treatment erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP) level, Lysholm knee joint function assessment scale score, Visual Analogue Scale (VAS) score for pain, and levels of CCL19, CXCL12, and RANKL in knee joint fluid were compared between the two groups. ResultsThe total effective rate of the observation group was higher than that of the control group (P＜0.05). After treatment, ESR, serum CRP level, VAS score for pain, and levels of CCL19, CXCL12 and RANKL in knee joint fluid were decreased, and Lysholm knee joint function assessment scale score was elevated in the two groups as compared with before treatment, as well as the aforementioned indices in the observation group were superior to those in the control group (P＜0.05). ConclusionClinical effect of minimally invasive needle-knife endoscopy combined with DMARDs for the treatment of RRA is superior to single DMARDs therapy, which can significantly alleviate clinical symptoms, disease activity, and inflammatory response in patients, and it may be related to effective decreases of CCL19, CXCL12 and RANKL levels in knee joint fluid.

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