[Recent advances in upper extremity surgery for rheumatoid arthritis]

Area of Science:

• Orthopedic Surgery
• Rheumatology
• Joint Reconstruction

Background:

• Rheumatoid arthritis (RA) significantly impacts joints, necessitating surgical interventions.
• While pharmacologic control has advanced, surgical options remain crucial for RA management.
• Specific joint involvement in RA requires tailored surgical approaches.

Purpose of the Study:

• To review current surgical procedures for rheumatoid arthritis affecting major joints.
• To evaluate the efficacy and indications of various arthroplasty techniques in RA.
• To assess outcomes for arthroscopic synovectomy, shoulder, elbow, and proximal interphalangeal joint replacements in RA.

Main Methods:

• Literature review of surgical interventions for RA.
• Analysis of outcomes for arthroscopic synovectomy, total shoulder arthroplasty, reverse shoulder arthroplasty, total elbow arthroplasty, and proximal interphalangeal joint replacement.
• Assessment of patient satisfaction, functional outcomes, and complication rates.

Main Results:

• Arthroscopic synovectomy remains valuable alongside medical management for RA.
• Total shoulder arthroplasty is effective for glenohumeral joint destruction without rotator cuff issues.
• Reverse shoulder arthroplasty shows promise but requires careful patient selection for rheumatoid shoulders.
• Total elbow arthroplasty provides reliable long-term reconstruction for rheumatoid elbows.
• Proximal interphalangeal joint replacement offers pain relief and aesthetic improvement despite functional limitations.

Conclusions:

• Surgical management of RA joints is evolving, with arthroplasty being a key component.
• Appropriate patient selection and surgical technique are critical for optimal outcomes in RA joint reconstruction.
• While challenges exist, joint replacement surgery provides significant benefits for pain and function in RA patients.