Clinica Ortopedica, ASST Centro Specialistico Ortopedico Traumatologico Gaetano Pini-CTO, Milan, Italy.
Laboratory of Applied Biomechanics, Department of Biomedical Sciences for Health, Università degli Studi di Milano, Milan, Italy.
Adv Ther. 2018 Aug;35(8):1133-1139. doi: 10.1007/s12325-018-0750-9. Epub 2018 Jul 11.
Since its introduction, total joint arthroplasty (TJA) has improved the quality of life of patients with degenerative joint disorders. In the last decades, a number of conventional and biological disease-modifying antirheumatic drugs have become available for the treatment of patients with inflammatory rheumatic diseases (IRD), leading to a reduction in the need to undergo TJA. However, TJA is still frequently performed in IRD patients. Both rheumatologists and orthopedics should be aware that patients with IRD have a peculiar perioperative risk profile due to disease-related, patient-related, and surgery-related risk factors. On the basis of current evidence, TJA is a safe procedure for IRD patients as long as an accurate risk stratification and a multidisciplinary approach are applied. We here describe the current strategies for an appropriate surgical management of osteoarthritis in IRD patients and the fascinating opening perspectives that surgeons and clinicians may expect in the future.
自问世以来，全关节置换术（TJA）改善了退行性关节疾病患者的生活质量。在过去的几十年中，许多常规和生物疾病修饰抗风湿药物已可用于治疗炎性风湿性疾病（IRD）患者，从而减少了 TJA 的需求。然而，TJA 仍经常在 IRD 患者中进行。风湿病学家和骨科医生都应该意识到，由于与疾病相关、与患者相关和与手术相关的风险因素，IRD 患者具有独特的围手术期风险特征。基于目前的证据，只要采用准确的风险分层和多学科方法，TJA 对 IRD 患者来说是一种安全的手术。我们在这里描述了目前针对 IRD 患者骨关节炎进行适当手术治疗的策略，以及外科医生和临床医生未来可能期待的令人兴奋的前景。
