YNOVECTOMY is now an established s therapeutic procedure in adults with rheumatoid arthritis.1~~*~ Its use in children has been limited,* yet it is obvious from discussion with experts in the field of arthritis that frustration exists in the management of adults with severe deformities who contracted the disease in childhood. In October, 1967, we surveyed by letter 22 authorities on rheumatoid arthritis in this country and abroad who had acquaintance with synovectomy. There was nearly uniform agreement that synovectomy for juvenile rheumatoid arthritis was a satisfactory procedure that should be done more often.
The rheumatologists surveyed were asked what criteria were used to select their patients for synovectomy. Although formal criteria for selection and for preoperative and post-operative followup were being developed in only one institution, there was agreement as to the general criteria for selection, an agreement which will be amplified upon further below.
There was general agreement that corrective procedures such as osteotomies and arthrodeses have a very useful role in juvenile rheumatoid arthritis, as they have in adult disease. Arthroplasty is sufficiently rare in children that discussion of these procedures would be premature.