Einstein (São Paulo) (Mar 2008)
Orthopaedic surgeries in rheumatic patient
Abstract
Rheumatoid arthritis is the most common rheumatic disease thatneeds surgical intervention. The most affected joints are the wrists,metacarpophalangeal, interphalangeal, metatarsophalangeal, andknees. The others joints are affected in the development of thedisease. During its progression, the infl ammatory process extendsto the periarticular structures of the connective tissue as tendonsand ligaments. These involvements of soft tissue with osteoarticularinvolvement lead to instability and deformities. Open or arthroscopicsynovectomies lead to pain relief, while tenotomies and tendonstransfer aim to correct deformities, as well as regain function of thejoint. Arthroplasty is an excellent choice in order to have a goodrange of motion, functional and not a painful joint. Arthrodesis ischosen, when there is an intense articular involvement and there isno indication for arthroplasty. Although, it limits the range of motionit can achieve pain relief and function, when performed in the rightangle of fl exion and extension.
