.An Inslrnclional Course Lecture, The Anlerican Academy of Orlhopaedic Surgeons

JIuch of the increasing enthusiasm for surgical treatment of rheumatoid arthritis revolves around preventing the destruction of cartilage and tendon simply by excising as much as possible of the tissue that produces the destruction, namely the inflamed synovial membrane. The basic objectives of surgery for this condition in the lower extremity are to preserve articular surfaces, to relieve pain and swelling, to correct deformity, and to improve motion and function. Surgical treatment of the knee has had considerable success for many years, and much of our kno~vledge of the surgical treatment of rheumatoid arthritis is based on experience with the knee. The Knee The primary aim of surgical treatment ' for rheumatoid arthritis of the knee is to preserve the articular surfaces as much as possible and to relieve pain and swelling. Relative to this end, synovectomy probably is the earliest and most rewarding procedure that can be done. The indication for synovectomy, hn.;icully, is failure to respond to medical management. ~ I ignon, in 1900, was the first t