EFFECT OF EARLY SYNOVECTOMY ON THE COURSE OF RHEUMATOID-ARTHRITIS

Ninety-one patients with rheumatoid arthritis were retrospectively assigned to 3 subsets according to the number of joints with erosion (NJE). The subsets were least erosive (LES): more erosive (MES); most erosive involving mutilating disease (MUD). In the early stages of disease the subsets were distinct (p < 0.001) regarding mean values of annual reduction of carpal height (DELTA-CHR) and serum Clq levels. Patient assessments (radiographic and clinical) continued to deriorate in the MES and MUD subsets over the 1-5 year interval after synovectomy. Apparent stabilization of knee disease in the LES subset may be a feature of this subset rather than a result of synovectomy. Although synovectomy may offer short term symptomatic relief, we found no evidence that it retards the bony destruction or the disease process.