Experience with knee synovectomy in Norwich, 1964-1973.

Thirty-six patients (43 knees) who underwent anterior synovectomy for rheumatoid disease between 1964 and 1973 have been personaly reviewed. The notes and X-rays of a further seven patients (10 knees) have been examined. Twenty-five per cent of the knees were failures at the time of review, but only two were failures from the outset. The indications for the operation and also the contraindications are described and evaluated. It is concluded that: 1. In the rheumatoid knee, anterior synovectomy is a pain relieving operation. 2. The indications are wider than classically stated, and can include knees with full thickness cartilage destruction, and flexion deformities up to 20 degrees. 3. The majority of knees fail because of secondary degenerative change, and this is manifested by pain rather than stiffness. 4. Postoperative manipulation does not prejudice the final result. 5. Associated popliteal cysts (five in this series) can be cured by anterior synovectomy.