Arthroscopic synovectomy. When, which diseases and which joints.

The success of arthroscopic synovectomy depends both on surgical skill and patient selection. Close cooperation between rheumatologist and rheumasurgeon is advocated. Alternative local joint treatments are discussed, with particular respect to radiation synovectomy. Patients with chronic inflammatory joint disease comprise the major group of patients. However, other diseases like haemophilia, pigmented villonodular synovitis, synovial chondromatosis, posttraumatic synovitis and septic arthritis are also discussed. A discussion of open versus arthroscopic synovectomy for each joint is presented. Arthroscopic synovectomy is preferred when arthroscopic access allows radical synovectomy. Treating concomitant tenosynovitis is underlined.