From the Department of Orthopaedic Surgery, Louisiana State University Health Sciences Center, New Orleans, LA (Dr. Cohen-Rosenblum); the Texas Orthopedics; Affiliate Faculty, Department of Surgery and Perioperative Care, Dell Medical School, The University of Texas, Austin, TX (Dr. Somogyi); the Department of Orthopaedic Surgery and Rehabilitation, University of Chicago Medicine, Chicago, IL (Dr. Hynes); and the Department of Medicine, Section of Rheumatology, Louisiana State University Health Sciences Center, New Orleans, LA (Dr. Guevara).
J Am Acad Orthop Surg Glob Res Rev. 2022 Nov 8;6(11). doi: 10.5435/JAAOSGlobal-D-22-00216. eCollection 2022 Nov 1.
Gout is characterized by the deposition of monosodium urate crystals in patients with chronically elevated blood levels of uric acid. It is the most common form of inflammatory arthritis in the United States and is often comorbid with hypertension, obesity, and chronic kidney disease. Initial presentation is usually an acutely warm, swollen joint, most commonly the first metatarsophalangeal joint, but a variety of locations may be affected. The main treatment for gout is medical management of acute inflammation and chronic uric acid levels, but surgical treatment may be indicated in cases of damage to the surrounding soft tissue, concomitant septic arthritis, symptomatic cartilage loss, or neurologic deficits. Based on the literature to date, gout does not seem to independently affect outcomes after total hip, knee, and ankle arthroplasty, but associated comorbidities affecting outcomes in these patients should be considered.
痛风的特征是尿酸水平长期升高的患者体内单钠尿酸盐晶体的沉积。它是美国最常见的炎症性关节炎形式，常与高血压、肥胖和慢性肾脏病并存。最初的表现通常是急性发热、肿胀的关节，最常见的是第一跖趾关节，但也可能影响多种部位。痛风的主要治疗方法是急性炎症和慢性尿酸水平的医学管理，但在周围软组织损伤、合并化脓性关节炎、有症状的软骨丧失或神经功能缺损的情况下，可能需要手术治疗。根据目前的文献，痛风似乎不会独立影响全髋关节、膝关节和踝关节置换术后的结果，但应考虑这些患者的相关合并症对结果的影响。
