Open surgical synovectomy of the knee in rheumatoid arthritis

Surgical Principles Although there has been an increase in the popularity of less invasive methods of synovectomy such as radiation synovectomy and arthroscopic synovectomy the open operation remains the procedure of choice in the management of severe synovitis of the knee joint even quite late in the disease process. Removal of all the chronically inflamed synovial tissue does seem to control the disease at a local level in the majority of cases. The operation should not be performed in a grossly destroyed joint with significant bone loss from the articular surfaces.