Klein Céline, Barbier Vincent, Glorion Christophe, Gouron Richard
Department of Paediatric Orthopaedics, Amiens Picardie University Hospital, University of Picardie Jules Verne, 80054 Amiens, France.
MP3CV-EA7517, CURS-Amiens University Hospital, Jules Verne University of Picardie, 80000 Amiens, France.
J Clin Med. 2023 May 11;12(10):3402. doi: 10.3390/jcm12103402.
Juvenile idiopathic arthritis is the most common chronic rheumatic disease encountered in children under the age of sixteen and causes significant impairments in daily life. Over the last two decades, the introduction of new drug treatments (including disease-modifying antirheumatic drugs and biologics) has changed the course of this disease, thus reducing the indication for surgery. However, some patients fail to respond to drug therapy and thus require personalized surgical management, e.g., the local reduction of joint effusion or a synovial pannus (via intra-articular corticosteroid injections, synovectomy, or soft tissue release), and management of the sequelae of arthritis (such as growth disorders and joint degeneration). Here, we provide an overview of the surgical indications and outcomes of the following interventions: intra-articular corticosteroid injections, synovectomy, soft tissue release, surgery for growth disorders, and arthroplasty.
幼年特发性关节炎是16岁以下儿童中最常见的慢性风湿性疾病，会对日常生活造成严重损害。在过去二十年中，新药物治疗方法（包括改善病情抗风湿药和生物制剂）的引入改变了这种疾病的病程，从而减少了手术指征。然而，一些患者对药物治疗无反应，因此需要个性化的手术管理，例如局部减少关节积液或滑膜血管翳（通过关节内注射皮质类固醇、滑膜切除术或软组织松解），以及处理关节炎的后遗症（如生长障碍和关节退变）。在此，我们概述以下干预措施的手术指征和结果：关节内注射皮质类固醇、滑膜切除术、软组织松解、生长障碍手术和关节成形术。
