Synovectomy of the Hip in Juvenile Rheumatoid Arthritis

Review of the results of subtotal and complete synovectomy of 9 hips in 5 female patients with subluxation or progressive joint destruction (roentgenographically) than any 2 years showed improvement or retention of joint motion in 4 patients. Complete synovectomy, performed in 7 hips, necessitated surgical dislocation of the joint, but there was no evidence that this surgical dislocation comprised the proximal femoral blood supply. The mildest synovial and cartilagenous changes were present in the patient who has bilateral partial synovectomies. At follow-up these hips showed more severe destruction evaluated during a minimum of the hips treated by total synovectomy. No postoperative dislocations occurred. Synovectomy of the hip may be useful for progressive hip involvement in younger patients whose skeletal immaturity contraindicates major reconstructive procedures.