[Surgery of juvenile chronic arthritis]

A number of surgical procedures can be proposed in juvenile chronic arthritis (JCA). These are particularly useful in two circumstances: 1), during the early stages of the disease, as local treatment for hyperplasic synovium (intra-articular injection or synovectomy) in order to avoid further articular destruction; 2) in the late stages of the disease with the aim of restoring function to as near normal as possible (osteotomy, arthrodesis, arthroplasty, tendon repair). However, in all circumstances, such surgery must be decided upon by a team consisting of paediatrician and orthopaedic surgeon. Procedures are often multiple and require careful preparation including psychological support, nutritional, medical and orthopaedic care. And should be followed by intensive and specific physiotherapy. When these conditions are fulfilled, the operative procedures may restore nearly normal joint function in severe forms of JCA, thus allowing children and adolescents to maintain good physical, intellectual and psychological development through independent mobility.