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 lo ng-term results of open knee synovectomy in later cases of rheumatoid arthr itis. Clinical findings in 93 knees after late open synovectomy are present ed. The average follow-up was 10.1 (6.4-12.7) years. The failure rate was 3 9.8 per cent and so in 60.2 per cent (56 knees) no further operation was ne cessary. In 12 of 37 cases the revision was done by resynovectomy and recon structive 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. Pat ients reported as well reduction of pain and swelling with a high grade of satisfaction. Despite these reasonable functional results, radiographic pro gression 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.