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Synovectomy for Rheumatoid Arthritis

Surgery Overview

Synovectomy surgery is done to remove inflamed joint tissue (synovium) that is causing unacceptable pain or is limiting your ability to function or your range of motion. Ligaments and other structures may be moved aside to access and remove the inflamed joint lining. The procedure may be done using arthroscopy.

What To Expect

As soon as possible after surgery, a physical therapist will teach you how and when to move the joint. Recovery depends on the surgical technique used and the location of the incisions.

Following knee synovectomy, your knee will be immobilized in a removable cast. And physical therapy is started after 1 to 2 days.

Why It Is Done

Synovectomy may be used to treat joints affected by rheumatoid arthritis that have minimal bone or cartilage destruction when medicine has not relieved pain.

Synovectomy may be considered if significant pain persists after 6 to 12 months of drug treatment, including the use of disease-modifying antirheumatic drugs (DMARDs).

How Well It Works

Synovectomy does not cure the disease. But it may relieve symptoms temporarily.footnote 1

Risks

Risks of synovectomy include the risks of surgery and using anesthesia and a slight risk of infection and bleeding within the joint.

There may also be a loss in the range of motion of the joint, or the inflammation in the joint may return.

What To Think About

Synovectomy is a useful treatment option for early rheumatoid arthritis that has not improved with medicine, including DMARDs or corticosteroid injections. It may provide only temporary relief.

References

Citations

  1. Ekwall AKH, Firestein GS (2014). Rheumatoid arthritis: Treatment. In EG Nabel et al., eds., Scientific American Medicine, chap. 1032. Hamilton, ON: BC Decker. https://www.deckerip.com/decker/scientific-american-medicine/chapter/1032/pdf. Accessed December 15, 2016.

Credits

Current as ofJune 10, 2018

Author: Healthwise Staff
Medical Review: Anne C. Poinier, MD - Internal Medicine
Martin J. Gabica, MD - Family Medicine
Kathleen Romito, MD - Family Medicine
Nancy Ann Shadick, MD, MPH - Rheumatology


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