Role of early synovectomy of the knee joint in rheumatoid arthritis.

The prospective study of 32 knees in 26 patients with rheumatoid arthritis was carried out with an average followup of 3 years. Relief of pain and control of inflammation locally were obtained in 22 of 32 knees (69%). Articular cartilage was preserved in 20 of 28 knees (71%) and the synovitis recurred in 9 knees (28%), 7 of which showed progressive loss of cartilage. Therefore, it appears that synovectomy, if performed at a stage in which articular cartilage is still normal and after medical therapy has failed, is a very effective method for preserving articular cartilage and controlling inflammation locally. However, with a longer followup the disease with loss of articular cartilage will recur in a large number of cases. In patients whose disease progresses rapidly, no form of therapy effectively controls joint destruction.