50 Arthroscopic Synovectomy

• Standard wrist arthroscopy setup is used.
  
• Use the 3-4, 4-5 or 6R, and radial and ulnar (RMC-UMC) midcarpal portals to inspect the joint and for synovectomy (Fig. 50-1).
  
• Shaver, punch, and radiofrequency devices can all be used.

Pitfall

Establish high fluid outflow to avoid excessive heat if radiofrequency devices are used.

• Use a systematic approach beginning from the center of the radiocarpal joint and progressing radial and ulnar.
  
• Synovitis is typically greatest in the prestyloid recess, along the dorsal capsule, and near the radial styloid (Fig. 50-2A-C).

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