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First published online December 17, 2007
Clinical Medicine & Research
Volume 5, Number 4 : 244 -250
doi:10.3121/cmr.2007.768
© 2007 Marshfield Clinic
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Review

Arthroscopic Synovectomy in Rheumatoid Arthritis of Wrist

Sung-Jae Kim, MD, PhD and Kwang-Am Jung, MD

Sung-Jae Kim, MD, PhD, Department of Orthopaedic Surgery Yonsei University College of Medicine Seoul, Korea
Kwang-Am Jung, MD, Department of Orthopaedic Surgery Himchan Hospital Seoul, Korea

Reprint Requests: Kwang-Am Jung, MD, Department of Orthopaedic Surgery, Himchan Hospital, 404-3, Mok-dong, Yangcheon-Ku, 158-806 Seoul, KOREA, Tel: 822-3219-9114, Fax: 822-3219-9126, Email: osjka{at}dreamwiz.com

The wrist is the most commonly involved region of the upper extremity in rheumatoid arthritis (RA). Because the wrist joint becomes involved early during the disease course and its involvement rapidly progresses, and because the disabilities associated with progressive RA are significant, early and adequate treatment must be introduced to prevent disease progression. Various treatment methods can be employed to treat RA wrists based on radiological and clinical findings. Arthroscopic synovectomy is recommended for pain relief and functional recovery in early stage RA, and is also helpful in advanced staged RA with Larsen stage III. However, arthroscopic synovectomy is not recommended as an effective method of treatment for all patients with advanced radiographic changes. Nevertheless, arthroscopic synovectomy may delay the need for complex surgery, such as wrist arthrodesis or total wrist arthroplasty in selective cases. Although arthroscopic synovectomy of the wrist cannot improve grip strength or range of motion, it can reduce wrist pain and improve function, and thus facilitate return to work.

Key Words: Arthroscopic synovectomy, Larsen stage III • Rheumatoid arthritis • Wrist






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