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1. One hundred and twenty-three patients with rheumatoid arthritis who had synovectomy and excision of the head of the radius performed on 154 elbows have been reviewed one to six years after operation.

2. The severity of the disease process at the time of operation was graded radiologically and an attempt made to relate this to the results.

3. Overall, the clinical results were most satisfactory; more than 70 per cent of the patients were pleased with the outcome. When radiographic deterioration of the joint was taken into account, however, only 54 per cent achieved a "satisfactory" result.

4. Clearance of the synovium through combined medial and lateral incisions gave better results than a lateral approach alone.

5. When the disease was far advanced by the time of operation any good results were likely to be short-lived.

6. The indications for synovectomy of the rheumatoid elbow are discussed in the light of these findings.

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