[Surgical treatment of rheumatoid arthritis]

Synovectomy, total arthroplasty and arthrodesis are the main surgical methods for rheumatoid arthritis. Although recurrent synovitis and radiological deterioration after synovectomy have been reported, the procedure can be an effective treatment if it is performed in the early stage where articular cartilage and bone are minimally damaged. Arthrodesis is indicated for severely destroyed joints. However, since loss of motion in the proximal joints often leads to severe disability, its indication is limited to the distal joints, such as the wrist and ankle. Total rthroplasty seems to be an ideal method because relief of pain and recovery of function can be obtained simultaneously. However, there are some complications, such as loosening and wear of the prosthesis. Solution of these would bring much benefit to the disabled rheumatoid arthritis patient.