Arthroscopic Synovectomy Combined With DMARDs in the Treatment of Refractory Elbow Rheumatoid Arthritis

Inclusion Criteria: * The patients who fulfilled the 1987 ACR（American College of Rheumatology) or 2010 ACR/EULAR（European League Against Rheumatism） RA classification criteria. * The age is more than 18 years old and less than 60 years old. * They received stable traditional DMARDs (including Chrysopidae, leflunomide, sulfasalazine, hydroxychloroquine, eilamod) or biological dmrads (including tumor necrosis factor antagonists, IL(Interleukin)-6 receptor antagonists, CD20 monoclonal antibodies) for at least 6 months. * The disease is still in the active stage, which means the disease activity score (DAS28) is more than 3.2, and the elbow joint function is obviously limited. * The patient agreed to undergo arthroscopic synovectomy. * No contraindications were found. Exclusion Criteria: * The disease is in remission. * The patient has contraindications. * Arthroscopic synovectomy was performed in different patients.