There is no evidence to support the use of synovectomy in TKA for primary OA, as it provides no clinical benefit and increases postoperative blood loss.

I ever excise the (often hypertrophied) synovium at the  anterior cortical of femoral metaphysis ; I want to have the best mark possible for my use of anterior reference in TKR; using a diathermy knife there is no more blood loss ; the 2 days ropivacaïne with adrenalin (as part of fast track) substantially limits blood loss anyway;

I just do removal of the synovium in patients with rheumatoid arthritis. In cases of osteoarthritis I perform a partial resection within the limits of articular cartilage. The resection always perform with diathermy knife. I have not detected in these cases increased postoperative bleeding

We remove extensively hipertrophied synovium as a routine with diatermic knife. Though complete removal is not crucial so it is when synovium is not hypertrofied. It seems it is removed mostly to avoid impingement and reduce inflamation. There are a few randomised works i.e. of Zhaoning et al and Kilicarslan in this matter.

I routinely excise the hypertrophied synovium in the suprapatellar pocket because it can be source for inflammation and a stubborn and very troublesome  synovitis postoperatively. It is important to excise only the synovial membrane and leave in situ the prefemoral fat tissue. Sometimes both structures are removed together which can lead to restricted ROM postoperatively.

I excise the synovium only if it is hypertrophic and/or showing signs of inflammation. I do not used diathermy as there is the risk to remove more tissue than it is necessary. I leave the pre-femoral tissue and I do not denude the bone. I use nibblers and the synovium is easily pealed out separating itself for the rest of the tissues without any effort. This way I found out that I minimise the bleeding post-operatively. The reason for removing it is the post-operative repeated effusions that the synovium can produce and due to the swelling the dissatisfaction of the patient and the limitation of the range of movements. I am trying to not use cutting diathermy as there is possibility to increase the adhesions and restrict the movements.

I shown this technique by a prominent Knee Surgeon when I was senior registrar and I do not regret it as by changing my previous applied routine of removing the synovium for every case and by using cutting diathermy I found that the ROM of the joints improved considerably.

I also prefer excision of the synovium as much it is possible special in suprapatelar recessus, because hypertrophic synovium my cause postoperative joint effusion.

I excise the hypertrophic synovium but not extensivelly. It is only with the porpouse of diminishing swelling and impingement at the postop. It helps also in the sooner recuperation of range of motion.

I usually remove suprapatellar synovium tissue.Why?Two reasons: fistly, synovium tissue is a rich source of nerve endings ( TKA is a procedure to reduce joint pain);secondly, for exposure purposes ( anterior femoral cortical).

I would only consider a synovectomy in cases where the synovium is hypertrophied like in R.A. and sometimes in knees where the synovium is markedly thickened and abnormal restricting movement. No place in a straight forward degenerative knee with mild synovitis

I only removed synovium  parcially  to clean the place near to the implant

We only partially excise the synovium with knife or diathermy so that anterior cortex is visible for accurate sizing of the femoral component and so that no soft tissue interferes with implant Cementation. Whereas in rheumatoid patients a synovectomy is helpful symptomatically in the postop rehab period. 

Removal of the hypeertrofic syvium will lead you to a beter and faster recuperation of the ROM. Besides you need to perform a mesaurement  for the anterior cut of the condyles, therefore you need to expose the bone just above the trochlear knotch