Radical synovectomy with muscle release for the rheumatoid elbow.

Twenty-three synovectomies of the elbow with concomitant muscle release at the humeral epicondyles were performed in 21 patients with rheumatoid arthritis. Ten elbows were classified as anatomical Stage 2, 12 as Stage 3, and one as Stage 4. The patients were followed from 1 to 8 years. Postoperative clinical results showed improved relief of pain, and range of motion, and activities of daily living. Increased range of motion with improvement of flexion contracture was obtained in most cases by releasing the muscle insertions around the humeral epicondyles and by resecting the radial head and bony spurs of the coronoid and the olecranon. The operation was beneficial even at advanced stages.