[Indications and types of synovectomy].
Synovectomy is the routine surgical treatment for cases of therapy-resistant exudative synovitis or teno-synovitis, which are frequently seen in cases of rheumatoid arthritis and less frequently in synovial osteochondromatosis, pigmented villo-nodular synovitis and degenerative joint diseases. The best results are obtained following a so-called "early synovectomy", which means a synovectomy performed prior to the onset of destructive changes of bone and cartilage and before the occurrence of irreversible mechanical distension of ligaments and capsules. When carried out under the above mentioned conditions, complete local relief of pain can be achieved in nearly all cases. In rheumatoid arthritis the pain relief may be temporary or permanent depending on the disease progression in each individual case. Statistically, the danger of relapse increases in proportion to the length of time following synovectomy. Analogous results can be obtained by the use of chemical (osmic acid 2%) or radioactive (Er-165, Re-186, P-32, Y-90) synovectomy. Further experience with these agents will be necessary to determine to what degree they can replace surgical therapy.