Clinical observations indicate that the course of disease in patients with rheumatoid arthritis (RA) has become milder during the past decade.1 Less severe symptoms2 as well as the declining need for orthopaedic interventions3 4 are most likely the result of more potent drugs. However, there is an ongoing debate to what extent single surgical options such as joint-sacrificing arthroplasties or prophylactic synovectomies are affected within the surgical treatment concept. Therefore, we reviewed the electronic medical records in our orthopaedic clinic, which serves a huge regional population and is regarded as a reference clinic for RA patients over many years. Special characteristics of the clinic are a common treatment philosophy5 and a low turnover rate …