Rheumatoid arthritis surgical therapy

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Manpreet Kaur, MD [2]

Overview

The mainstay of treatment for rheumatoid arthritis is medical therapy. Surgery is usually reserved for patients with debilitating disease, failure of medical therapy, and radiographic findings of end-stage arthritis. Various surgical options used for the treatment of RA include tenosynovectomy, arthroscopic or open synovectomy, joint fusion, small joint implant arthroplasty, total joint replacement of deformed joint.

Indications

The mainstay of treatment for rheumatoid arthritis is medical therapy. Surgery is usually reserved for patients with following conditions:

Severe pain at rest and with movement
Failure of medical therapy
Radiographic findings of end-stage arthritis

Surgery

Various surgical options used for the treatment of RA are:^[1]^[2]

Tenosynovectomy:
- Used to repair the ruptured tendon.

Arthroscopic or open synovectomy:
- Used to excise inflamed tendon.
Joint fusion
Small joint implant arthroplasty
Total joint replacement of deformed joint

Contraindications

Various complications of surgery for rheumatoid arthritis may include:

Active systemic infection
Active joint infection

References

↑ Lisitskiy IY, Kiselev AM, Kiselev SE (2018). “[Rheumatoid atlanto-axial dislocation: a surgical approach]”. Zh Vopr Neirokhir Im N N Burdenko (in Russian). 82 (1): 41–47. doi:10.17116/neiro201882141-47. PMID 29543214.
↑ Cheikh AB, Maitigue MB, Masmoudi K, Mouelhi T, Naouar N, Grissa Y, Bouattour K, Osman W, Ben Ayeche ML (2017). “[Femoral varising osteotomy by external opening for the treatment of lateral femorotibial gonarthroses associated with idiopathic genu valgum: a retrospective a study of 10 cases]”. Pan Afr Med J (in French). 28: 22. doi:10.11604/pamj.2017.28.22.12014. PMC 5681007. PMID 29138658.

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[pmid29543214-1] Lisitskiy IY, Kiselev AM, Kiselev SE (2018). “[Rheumatoid atlanto-axial dislocation: a surgical approach]”. Zh Vopr Neirokhir Im N N Burdenko (in Russian). 82 (1): 41–47. doi:10.17116/neiro201882141-47. PMID 29543214.

[pmid29138658-2] Cheikh AB, Maitigue MB, Masmoudi K, Mouelhi T, Naouar N, Grissa Y, Bouattour K, Osman W, Ben Ayeche ML (2017). “[Femoral varising osteotomy by external opening for the treatment of lateral femorotibial gonarthroses associated with idiopathic genu valgum: a retrospective a study of 10 cases]”. Pan Afr Med J (in French). 28: 22. doi:10.11604/pamj.2017.28.22.12014. PMC 5681007. PMID 29138658.

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