Office-based arthroscopic synovectomy of the wrist in rheumatoid arthritis

We present an office-based technique for performing arthroscopic synovectom y of the wrist in patients with rheumatoid arthritis. Intra-articular anest hesia as well as subcutaneous portal anesthesia are used. Standard portals are used in the radial carpal and midcarpal joints. Standard instrumentatio n is used and the synovectomy is accomplished using a motorized shaver. We performed 30 procedures in 21 patients: 15 complete synovectomies, 3 radiou lnar carpal synovectomies because of only limited disease, and 12 limited s ynovectomies because these patients were participants in a clinical trial a nd required only limited synovectomy for investigational purposes. There we re no complications. Office-based arthroscopic synovectomy of the wrist in patients with refractory rheumatoid arthritis can be performed safety and e ffectively. This technique is useful in both a clinical as well as a resear ch setting.