A five-year follow-up of synovectomy of the proximal interphalangeal joint in rheumatoid arthritis

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Abstract
Proximal interphalangeal joint synovectomy is associated with a high recurrence rate, particularly in the presence of severe active disease; this is similar to synovectomy at other sites. Nevertheless, despite this, and frequent radiological deterioration, relief of pain and some improvement in grip was present in 60% of patients five years after surgery. It would appear that this procedure should be advised when only a few joints are involved and are causing severe pain, in a patient who has only moderately active disease. It should also be seriously considered in a patient where the prolific synovitis is causing deformation of anatomical structures; under such circumstances if the disease process is very active every effort should be made to control this with anti-rheumatic drugs such as gold and pencillamine.

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