Comparative evaluation of unilateral synovectomized rheumatoid wrist with the opposite, unoperated-on wrist.

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Unilateral wrists synovectomized in wrists bilaterally afflicted with RA in 20 patients were followed up for 5 years to 19 years, 12.9 years on an average. The unoperated-on wrist was evaluated as a control.<BR>Pain and swelling disappeared in 19 of the synovectomized wrists, whereas 5 of the unoperated-on wrists had pain and 6 swelling. In dorsal and volar flexion, both synovectomized and unoperated-on wrists exhibited a similar decrease in ROM; however, in the latter, forearm supination and pronation decreased to a lesser extent. X-ray examination revealed progression of the disease in both synovectomized and unoperated-on wrists. Most patients were satisfied with the results of the synovectomy, but a few complained of the decrease in dorsal and volar flexion.<BR>In conclusion, synovectomy of the rheumatoid wrist is recommended for alleviation of pain and swelling, but not for the prevention of the progression of bone destruction.
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