Comparison between arthroscopic and open synovectomy for the knee in rheumatoid arthritis

Ten surgical anterior capsulosynovectomies following Mori's four-block capsular incision technique in nine rheumatoid patients and 14 arthroscopic synovectomies utilizing a Wolf arthroscope with a large pituitary rongeur or a motorized intra-articular shaver in 11 patients were performed in our department. In three patients with bilateral involvement at nearly the same stage (III), we operated on the knees simultaneously, using open capsulosynovectomy on one side and arthroscopic synovectomy on the other side; we comparatively assessed the postoperative course, the subjective evaluation of the patients, and the follow-up results. Surgical intervention is milder in the arthroscopic operation, and postoperative knee pain during motion exercise is markedly less in the arthroscopically synovectomized knee. Although the postoperative management was more complex for open capsulosynovectomized knees, the results obtained at 1-2 months after synovectomy showed no significant difference between the two procedures.