Synovectomy of the elbow in rheumatoid arthritis

The combined procedure of synovectomy and resection of the radial head was performed in thirty-five patients (forty-two elbows) with Stage-III or IV rheumatoid arthritis. These patients were followed postoperatively for a minimum period of two years (average, seven years). The result was graded as excellent in four, good in fifteen, fair in fourteen, and poor in nine elbows. Pain was diminished from the preoperative level in all but six elbows, but motion was not much improved. Synovitis recurred postoperatively in thirteen elbows, but in only five did the destructive process progress to a degree requiring a second operation. We think that synovectomy for relief of pain in the elbow is not contraindicated in the presence of Stage-III or IV rheumatoid disease, but that little improvement of elbow motion can be expected.