[Long-term results of open knee synovectomy in later cases of rheumatoid arthritis].

Open synovectomy of the knee in early cases has become a standard procedure in rheumatoid patients. Therefore, this study was performed to evaluate long-term results of open knee synovectomy in later cases of rheumatoid arthritis. Clinical findings in 93 knees after late open synovectomy are presented. The average follow-up was 10.1 (6.4-12.7) years. The failure rate was 39.8 per cent and so in 60.2 per cent (56 knees) no further operation was necessary. In 12 of 37 cases the revision was done by resynovectomy and reconstructive surgery. Thus during the follow-up period (10.1 years) in 73.1 (n=68) per cent of knee synovectomy no knee arthroplasty was performed. Patients reported as well reduction of pain and swelling with a high grade of satisfaction. Despite these reasonable functional results, radiographic progression of disease (Larsen stage 2.2 to 3.7) is common after synovectomy. Our study shows that late open synovectomy can delay the need for definite replacement surgery in nearly three-quarters of the patients.