Effect of early synovectomy on the course of rheumatoid arthritis

Ninety-one patients with rheumatoid arthritis were retrospectively assigned to 3 subsets according to the number of joints with erosion (NJE). The subsets were least erosive (LES); more erosive (MES); most erosive involving multilating disease (MUD). In the early stages of disease the subsets were distinct (p less than 0.001) regarding mean values of annual reduction of carpal height (delta CHR) and serum Clq levels. Patient assessment (radiographic and clinical) continued to deteriorate in the MES and MUD subsets over the 1-5 year interval after synovectomy. Apparent stabilization of knee disease in the LES subset may be a feature of this subset rather than a result of synovectomy. Although synovectomy may offer short term symptomatic relief, we found no evidence that it retards the bony destruction or the disease process.