Synovectomy and radial head excision in rheumatoid arthritis:11 patients followed for 14 years

Surgical treatment

“…Some researchers consider this method to be preferable in all cases, even in advanced disease, since it is less difficult and less expensive. Furthermore, it reportedly has fewer complications than prosthetic surgery while the long-term outcome is not substantially less favorable (6,54).…”

“…Many retrospective studies, usually with a short followup times, have reported that synovectomy relieves pain substantially or completely in 60% (mean) of the patients (6,54,(60)(61)(62)(63)(64)(65). In these studies, improvement in elbow mobility was, however, insignificant.…”

The elbow

“…On the contrary, that synovectomy is an alternative superior to prosthesis, since it is easier and less expensive to perform and has fewer complications, but still with long-term results comparable to those of prostheses [11,38]. The results concerning pain relief are, however, clearly inferior to those achieved by prosthetic surgery.…”

“…It is also difficult to evaluate the effects of this procedure in patients also having the disease in the shoulder and hand/wrist, the intensity of which may also differ preoperatively compared to postoperatively. Table 1 shows clinical results of synovectomy in the elbow [2,9,11,27,34,37,38,39]. Of 429 operated elbows, 60 (58-74)% had no or only negligible pain from the elbow.…”

Surgical treatment--general opinions

“…Good results have been reported from several centers, mainly in Scandinavia [10,17,18,22]. Several studies have shown that the operation can effectively reduce inflammatory symptoms in a joint, but no scientific evidence shows that synovectomy prevents progressive joint destruction [1,2,5,9,15,21,23].…”