Introduction to orthopaedic surgery in rheumatoid arthritis

Surgical treatment of rheumatoid arthritis dates back some fifty years to when rheumatology developed into a separate branch of medicine. An interdisciplinary approach to rheumatoid arthritis was then introduced at a few specialized centres. By refining the surgical techniques, increasing the number of surgical options to be more precisely defined, this fifty years' experience in the surgery of rheumatoid arthritis has led to the good results that can be achieved today. The goals of the surgical treatment of rheumatoid arthritis are pain relief, improvement of joint motion or stability and correction of deformities. In addition, progression of the disease is likely to be halted in the operated joint. Operations may be classified as either preventive or reconstructive; sometimes they are both. Surgery is indicated when medical treatment fails to adequately check progression of the disease. Absolute indications include tendon ruptures, nerve compression, instability of the cervical spine associated with neurological symptoms, and severe deformities.