The practice of medical and surgical synovectomy: a UK survey

Radiation, chemical and surgical synovectomy are therapeutic options in the treatment of chronic synovitis, but the evidence for their efficacy is limited. The aim of this survey was to compare the frequency of, and the factors affecting the use of, the three types of synovectomy in the last 2 years in the UK. Questionnaires were sent to all consultant rheumatologists and orthopaedic surgeons in the UK. Completed questionnaires were received from 294 rheumatology and 832 orthopaedic NHS consultants currently practising in the UK. Replies from the rheumatologists showed that surgical synovectomy was used most frequently, followed by radiation synovectomy (175 and 160 consultants respectively). Only 33 consultants had used chemical synovectomy. Only 314 of the 832 (38%) orthopaedic consultants who replied had performed surgical synovectomies in the last 2 years; 195 had used an arthroscopic procedure and 193 an open procedure. For all three therapies, the knee was the most commonly treated joint.