Treatment of the ankle joint in rheumatoid arthritis with surgical and radiation synovectomy

Results of surgical synovectomy and radiation synovectomy (radiosynoviorthe sis) of the tibiotalar joint in rheumatoid patients are reported. The stage d concept for management of the rheumatoid ankle joint is presented which i s based on the radiographic appearance of disease progression. Results of 1 6 rheumatoid patients with disease to the ankle joint suggest that pain and walking capability is positively influenced by synovectomy and radiosynovi orthesis. Follow-up of 30 months revealed no deterioration of postoperative clinical improvement. In the absence of contraindications to radiosynovior thesis it is suggested to combine arthroscopic synovectomy with radiosynovi orthesis for the treatment of early stages of rheumatoid disease of the ank le joint. Open synovectomy is prefered to arthroscopic synovectomy, if teno synovectomy is simultaneously required.