Synovectomy of the elbow in rheumatoid arthritis.

概要

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Thirty five synovectomies of the elbow were evaluated in twenty nine patients with rheumatoid arthritis. The radial head was only conserved in four elbows and a silastic implant was used in fifteen of thirty one synovectomies combined with resection of the radial head. Almost all patients had an advanced stage of the disease, with disintegration of cartilage and severe erosions of bone. These patients were followed postoperatively for a minimum period of one year and an average of 5.4 years.<BR>The improvement in motion was slight in flexion and extention, and evident in rotation of the forearm. Pain was diminished in all but six elbows. Two-thirds of the patients were satisfied with the results of the operation, especially with respect to the relief of pain.<BR>From these results it appears that synovectomy combined with radial head resection and insertion of a silastic implant is the most useful treatment for reconstruction of severely destructed elbows. Moreover, the ulnar end may be resected at the same time if severe arthritis is present.
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