Waxman J
South Med J. 1977 Mar;70(3):270-3, 285.
The state of the art in the surgery of rheumatoid joint disease is discussed with emphasis on guidelines for choosing the patients and the types of procedures available. Strong-willed, strong-boned, strong-muscled, and well-informed patients are the best candidates. Synovectomy is particularly useful in the minimally erosive stages of the disease when the active synovitis is not suppressed by one or more steroid injections or other modalities of therapy. Arthrodeses and arthroplasties are midstage procedures that are now being supplanted by total joint replacement. This is especially true of the knee, but new prostheses for elbows, shoulders, wrists, and ankles are on the horizon.
本文讨论了类风湿性关节疾病手术的最新技术，重点是选择患者的指南以及可用的手术类型。意志坚强、骨骼强壮、肌肉发达且见多识广的患者是最佳人选。滑膜切除术在疾病的轻度侵蚀阶段特别有用，此时活跃的滑膜炎不能通过一次或多次类固醇注射或其他治疗方式得到抑制。关节固定术和关节成形术是中期手术，现在正被全关节置换术所取代。膝关节尤其如此，但肘部、肩部、腕部和踝部的新型假体也即将出现。
