RESUMO
Even though the paradigm shift was occurred in treatments for rheumatoid arthritis (RA), some patients are not well controlled with several treatments. Because arthroscopic techniques advanced remarkably, effectiveness of arthroscopic synovectomy is reconsidered, especially for residual synovitis in biologics unresponders. A combined therapy with biologics and arthroscopic synovectomy leads to improvement of composite measures such as DAS28. Arthroscopic synovectomy can be a powerful tool for the tight control in RA treatments. In addition with progressions of ultrasonography, ultrasound-guided regional anesthesia became popular recently. Using this technique, we can expand indication of surgical intervention even in patients with severe lung problems.