Hyman B S, Gregg J R
Robert Wood Johnson Medical School, New Brunswick, New Jersey.
Rheum Dis Clin North Am. 1991 Nov;17(4):971-83.
The primary reason for total hip and total knee replacement in patients with juvenile rheumatoid arthritis is marked functional impairment. Secondary reasons are severe disabling pain and deformity. By the time a patient is ready for arthroplasty, alternatives to surgery have already been considered; synovectomies, soft-tissue releases, and osteotomies have already been performed, or the destructive process is too advanced for any form of therapy to have a considerable effect.
青少年类风湿关节炎患者进行全髋关节和全膝关节置换的主要原因是明显的功能障碍。次要原因是严重的致残性疼痛和畸形。当患者准备接受关节成形术时，已经考虑过手术以外的其他治疗方法；滑膜切除术、软组织松解术和截骨术已经实施过，或者破坏过程过于严重，任何形式的治疗都无法产生显著效果。
