In numerous puplications the results of synovectomy have been written about where either one or another viewpoint have been examined. In this publication, the attempt is made to collect as many parameters as possible so as to get a most objective picture of the therapeutic worth by studying 100 knee and 370 finger synovectomies. During the survey, among other points, the following important aspects were taken under consideration: The operative results were not evaluated by the operating surgeon, but by a rheumatologist who was not on the clinic staff. As is well known, it is difficult to evaluate the X-ray picture objectively, since very often "subjective impressions" prevail. Gschwend succeeded in setting up - mainly for the synovectomized finger joints - a comprehensive point system, so as not to leave the evaluation to chance. Besides the purely local joint condition, an internal rheumatological status, at the time of the operation and the follow-up examinations, with corresponding laboratory tests, was carried out and included in the evaluation. Finally, it should be pointed out that this is a long term study of 5 years, with various controls made in between. The examination of so-called control groups, for the present study, seems to us to be highly problematic and of little value for a statement. Essentially, only the local condition with respect to pain and swellings im proves, while the general activity of the inflammatory process as also the mobility and deformity of the synovectomized joints will only be somewhat influenced.

Early in its development, the subject matter of any field of surgery is too ill-defined and opinions are too fluid for the production of a book on the subject to be possible. Late in its development, controversy is at an end, and although it is still possible to produce a textbook, it is too late to produce a book that might stimulate discussion and crystallise ideas. This book has that objective, it being the Editor's view that the field of the surgical treatment of arthritis of the knee had reached an appropriate intermediate stage in 1978 when this text was written. Three broad issues stand out as being in need of resolution before the optimum form of surgical treatment for a given knee can be defined more convincingly than is possible at present: Firstly: What symptomatic and physical features of the knee are to be recorded pre- and post-operatively, upon the basis of which comparisons can be made between the results obtained by two different surgeons or with two different tech niques. The resolution of this issue requires general agreement not only upon what features of the knee should be recorded but, crucially, upon how these features should subsequently be presented so as to characterise a particular group of knees.