Rinonapoli E
Istituto di Ortopedia e Traumatologia, Università di Perugia, Italy.
Clin Exp Rheumatol. 1989 Sep-Oct;7 Suppl 3:S139-40.
Surgical treatment of rheumatoid arthritis dates back some fifty years to when rheumatology developed into a separate branch of medicine. An interdisciplinary approach to rheumatoid arthritis was then introduced at a few specialized centres. By refining the surgical techniques, increasing the number of surgical options to be more precisely defined, this fifty years' experience in the surgery of rheumatoid arthritis has led to the good results that can be achieved today. The goals of the surgical treatment of rheumatoid arthritis are pain relief, improvement of joint motion or stability and correction of deformities. In addition, progression of the disease is likely to be halted in the operated joint. Operations may be classified as either preventive or reconstructive; sometimes they are both. Surgery is indicated when medical treatment fails to adequately check progression of the disease. Absolute indications include tendon ruptures, nerve compression, instability of the cervical spine associated with neurological symptoms, and severe deformities.
类风湿关节炎的外科治疗可追溯到大约五十年前，那时风湿病学发展成为医学的一个独立分支。当时，一些专业中心引入了针对类风湿关节炎的多学科治疗方法。通过完善手术技术，增加手术选择并使其定义更加精确，这五十年来类风湿关节炎手术的经验带来了如今所能取得的良好效果。类风湿关节炎外科治疗的目标是缓解疼痛、改善关节活动度或稳定性以及矫正畸形。此外，手术关节的疾病进展可能会停止。手术可分为预防性或重建性；有时二者兼具。当药物治疗无法充分控制疾病进展时，就需要进行手术。绝对适应症包括肌腱断裂、神经受压、伴有神经症状的颈椎不稳以及严重畸形。
