We report the clinical and radiological results after arthroscopic synovectomy (41 knees) and open capsulosynovectomy (26 knees) in patients with rheumatoid arthritis, with an average follow-up of more than ten years. The clinical outcome was much the same in both groups, but there was gradual deterioration, especially after eight years. Radiological changes of osteoarthritis were worse in the knees treated by open capsulosynovectomy compared with the arthroscopic group. Arthroscopic synovectomy has many advantages and we believe that it is better than open capsulosynovectomy for patients with rheumatoid arthritis of the knee.

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Rheumatoid arthritis (RA) is a chronic, inflammatory, systemic disease characterized by joint pain and destruction. We describe the importance of early diagnosis, recording magnetic resonance images images at an early stage, monitoring disease progression using gliostatin purified in our laboratory, and sugar-chain analysis of RA serum IgG. For treatment of RA, cyclooxygenase-2-selective inhibitors, disease-modifying antirheumatic drugs, biological products, and the possibility of gene therapy are discussed. The development of therapeutic methods based on the elucidation of the pathology of RA has progressed markedly in the past decade, and further progress and the development of an early diagnostic method are expected.

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