Synovectomy

Synovectomy is a surgical procedure in which the synovial membrane lining a joint cavity or bursae is partially or completely removed. The synovial tissue is the source of abnormal inflammation, fluid production and bone erosion in diseases such as rheumatoid arthritis, pigmented villonodular synovitis, bursitis, and certain types of osteoarthritis. The goal of the operation is to reduce inflammation, relieve pain, improve joint function and prevent further joint damage.

The procedure can be performed through an open approach or less invasive techniques such as arthroscopy. In an open synovectomy, a larger incision provides direct access and is typically chosen when extensive disease is present or when other joint repair is required. Arthroscopic synovectomy uses small portals and a camera to mobilize and remove diseased synovium with minimal soft‑tissue disruption; it is suitable for knees, hips, shoulders and wrists. Minimally invasive percutaneous synovectomy can be performed under local anesthesia for smaller lesions or chronic bursae in elderly patients.

Patients are usually given general anesthesia for open surgery and regional or local anesthesia for arthroscopic procedures. After removal of the inflamed tissue, joint lavage and irrigation are common to clear debris. Post‑operative care involves pain management, physical therapy and gradual resumption of activity. Complications are uncommon but may include infection, bleeding, nerve injury or recurrence of synovial disease. Long‑term outcomes depend on the underlying disease; for rheumatoid arthritis, synovectomy may slow joint destruction but does not cure the systemic condition. In pigmented villonodular synovitis, synovectomy offers a high rate of disease control, though recurrence can occur and may require repeat procedures.