Results of elbow synovectomy in rheumatoid arthritis.

Synovectomy of the elbow was performed on 54 patients (70 elbows) with rheumatoid arthritis. The mean follow-up time was 7.5 years (range 1.5-22 years). Clinical evaluation showed marked relief of pain in 28 elbows (40%). In 27 cases (38.5%) the pain was moderate but still less than preoperatively. Severe pain was recorded in 15 cases (21.5%) at the time of check up. As to postoperative range of movement, the mean flexion are was 114.5 degrees and the mean rotation are 134.5 degrees. Latitudinal instability was recorded up to 5 degrees in 33 (47%) elbows, up to 10 degrees in 20 (28.5%), up to 15 degrees in 6 (8.5%), and more than 15 degrees in 11 (16%). The mean carrying angle was 10 degrees in valgus. Measurement of strength in flexion and extension showed a reduction of approximately 50% compared to age-matched healthy controls. Reoperations were performed in 10 elbows (14%); the interval between the primary synovectomy and second operation in these cases averaged 8 years.