Anderson Ronald J
Division of Rheumatology, Immunology and Allergy, Brigham and Women's Hospital, Boston, MA 02115, USA.
Hand Clin. 2011 Feb;27(1):21-5. doi: 10.1016/j.hcl.2010.10.007.
The clinical picture of rheumatoid arthritis (RA) is best viewed as a combination of systemic symptoms associated with the inflammatory process and articular symptoms related both to potentially reversible synovitis and structural damage brought on by inflammation. In simple terms, the treatment of inflammation is medical, and structural lesions often require surgical solutions. The prime indications for surgery in patients with RA are essentially determined by the patient and consist of a desire to obtain pain relief and/or functional improvement. Pain is difficult to quantify. Essential concepts regarding surgical intervention are that surgery is elective in all but a few rare situations and always requires local therapy. Any evaluation of surgical intervention must be based on its total effect on the patient. Although there have been immense advances in the surgical options for patients with rheumatoid arthritis over the last several decades, the role of specific procedures in the total picture has many areas of uncertainty and controversy.
类风湿关节炎（RA）的临床症状最好被视为与炎症过程相关的全身症状以及与潜在可逆性滑膜炎和炎症引起的结构损伤相关的关节症状的组合。简单来说，炎症的治疗是药物治疗，而结构损伤通常需要手术解决。RA患者手术的主要指征基本上由患者决定，包括缓解疼痛和/或改善功能的愿望。疼痛难以量化。关于手术干预的基本概念是，除了少数罕见情况外，手术都是选择性的，并且总是需要局部治疗。对手术干预的任何评估都必须基于其对患者的总体影响。尽管在过去几十年中，类风湿关节炎患者的手术选择有了巨大进展，但特定手术在整体情况中的作用仍有许多不确定和有争议的领域。
