Treatment of the ankle joint in rheumatoid arthritis with surgical and radiation synovectomy [Die behandlung des rheumatischen oberen sprunggelenks mit synovektomie und radiosynoviorthese]

Results of surgical synovectomy and radiation synovectomy (radiosynoviorthesis) of the tibiotatar joint in rheumatoid patients are reported. The staged concept for management of the rheumatoid ankle joint is presented which is based on the radiographic appearance of disease progression. Results of 16 rheumatoid patients with disease to the ankle joint suggest that pain and walking capability is positively influenced by synovectomy and radiosynoviorthesis. Follow-up of 30 months revealed no deterioration of postoperative clinical improvement. In the absence of contraindications to radiosynoviorthesis it is suggested to combine arthroscopic synovectomy with radiosynoviorthesis for the treatment of early stages of rheumatoid disease of the ankle joint. Open synovectomy is prefered to arthroscopic synovectomy, if tenosynovectomy is simultaneously required.