Joint synovectomy is the surgical removal of the synovial membrane, the tissue that lines the joint capsule.
Synovium surrounds the body’s joints and produces synovial fluid to help lubricate the joint enabling smooth movement. In cases of joint disease, the synovium becomes inflamed (synovitis) and produces excess synovial fluid containing an enzyme that can eat away the cartilage on the joint surface leading to bone on bone joint pain.
Synovectomy helps to relieve joint pain and improve the range of motion and ability to function.
Joint synovectomy is usually recommended by your surgeon when you have a painful disabling joint condition that does not respond to non-surgical treatments such as rest, medications (NSAIDs) or corticosteroid injections, and physical therapy. It is usually indicated in the following conditions:
Joint degenerative disorders such as osteoarthritis are an absolute contraindication for joint synovectomy procedure.
Painful joint conditions should be evaluated by an orthopedic surgeon for proper treatment.
Your surgeon will gather your medical history and perform a physical examination. Diagnostic studies will also be carried out such as:
Joint synovectomy can be performed as an open surgical procedure or arthroscopic surgery under general anesthesia. It is usually performed as an outpatient procedure.
The surgeon makes a few small incisions around the joint. In one incision, the arthroscope is introduced to view the interior of the joint. The other portals are used for the insertion of surgical instruments to remove the inflamed synovium in the joint. A sterile liquid is infused into the joint to help clear the debris. At the end of the procedure, the arthroscope and instruments are removed and the tiny incisions are covered with a bandage.
Advantages of arthroscopic synovectomy over open synovectomy include:
The post-surgical guidelines to be followed after joint synovectomy include:
Risks and Complications
As with all surgery, risks and complications can occur. The possible complications following synovectomy include:
infection, bleeding, nerve and blood vessel damage, damage to bone surface, and no relief of symptoms.
Synovium can grow back and may require repeat surgery.