Sanchez-Sotelo Joaquin
Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA.
Curr Rev Musculoskelet Med. 2016 Jun;9(2):224-31. doi: 10.1007/s12178-016-9328-9.
Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by peripheral polyarthritis. The elbow joint is estimated to be involved in 20 to 65 % of the patients with RA. The development of new pharmacologic agents and the adoption of early therapeutic interventions have translated into milder forms of polyarticular destruction. As a result, the traditional crippled rheumatoid patient has been replaced by rheumatoid patients with higher activity levels, higher expectations, and more demands on any reconstructive procedures performed. When nonoperative treatment is insufficient, surgery may be considered. Arthroscopic synovectomy has become the procedure of choice for rheumatoid patients with uncontrolled symptoms. Patients with more advanced joint destruction can be considered for elbow arthroplasty. Interposition arthroplasty may be considered for patients interested in avoiding the potential complications of elbow arthroplasty.
类风湿关节炎（RA）是一种以周围多关节炎为特征的慢性炎症性疾病。据估计，20%至65%的RA患者会累及肘关节。新型药物制剂的研发以及早期治疗干预措施的采用已使多关节破坏的形式更为轻微。因此，传统的残疾类风湿患者已被活动水平更高、期望更高且对任何重建手术要求更多的类风湿患者所取代。当非手术治疗不足时，可考虑手术治疗。关节镜下滑膜切除术已成为症状控制不佳的类风湿患者的首选手术。对于关节破坏更严重的患者，可考虑行肘关节置换术。对于有意避免肘关节置换术潜在并发症的患者，可考虑采用间置关节成形术。
