Rehart S, Henniger M
Klinik für Orthopädie und Unfallchirurgie, Agaplesion Markus-Krankenhaus, Frankfurter Diakonie-Klinken gGmbH, Wilhelm-Epstein-Str. 4, 60431, Frankfurt/Main, Deutschland.
Orthopade. 2012 Jul;41(7):546-51. doi: 10.1007/s00132-012-1960-5.
The most common joint destructive chronic inflammatory diseases in orthopedic rheumatology are rheumatoid arthritis, psoriatic arthritis and spondyloarthropathy. They usually have a multilocular, characteristic progressive joint destructive course, which must be taken into account when planning surgical treatment. The establishment of a sequence of surgical procedures with equivalent indications follows special rheumatologic orthopedic principles. The choice of surgical procedure depends on the joint, the surrounding soft tissues and stage of destruction but the increased surgical risk and complications caused by the disease, specific medications and frequent comorbidities also have to be considered. Due to numerous perioperative characteristics close interdisciplinary cooperation especially with internist rheumatologists, anesthetists and physiotherapists is essential for a successful rheumatologic orthopedic therapy.
在骨科风湿病领域,最常见的导致关节破坏的慢性炎症性疾病是类风湿关节炎、银屑病关节炎和脊柱关节炎。它们通常具有多灶性、特征性的进行性关节破坏病程,在规划手术治疗时必须予以考虑。确定具有同等适应证的手术程序序列遵循特殊的风湿骨科原则。手术程序的选择取决于关节、周围软组织以及破坏阶段,但疾病、特定药物和常见合并症所导致的手术风险增加和并发症也必须加以考虑。由于存在众多围手术期特点,尤其是与内科风湿病学家、麻醉师和物理治疗师密切的跨学科合作对于成功的风湿骨科治疗至关重要。