Ciaffi Jacopo, Bianchi Lorenzo, Di Martino Alberto, Faldini Cesare, Ursini Francesco
Medicine & Rheumatology Unit, IRCCS Istituto Ortopedico Rizzoli, 40136 Bologna, Italy.
Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, 40126 Bologna, Italy.
J Clin Med. 2024 Sep 19;13(18):5552. doi: 10.3390/jcm13185552.
Recent advancements in the treatment of psoriatic arthritis (PsA) have improved patient outcomes, but many still experience disease progression, potentially leading to joint replacement surgery. In this scoping review, we examine the relationship between PsA and orthopedic surgery, focusing on the risks and temporal trends of total hip arthroplasty (THA) and total knee arthroplasty (TKA), the prevalence of postoperative complications, and the effectiveness of these procedures in PsA. The included studies suggest that PsA patients have an overall higher risk of undergoing THA and TKA compared to the general population, but with temporal trends showing a decreased risk for patients diagnosed in recent years. Acute complications, such as renal failure, stroke, and postoperative infections, may be more common in PsA patients than in those with osteoarthritis after THA and TKA. No significant differences were found in pain, function, or satisfaction between PsA, skin psoriasis, and osteoarthritis patients after THA. A key conclusion from our review is the need to strengthen the collaboration between rheumatologists and orthopedic surgeons, as interdisciplinary evaluation is crucial for improving the outcomes of PsA patients undergoing orthopedic surgery.
银屑病关节炎（PsA）治疗方面的最新进展改善了患者的治疗效果，但仍有许多患者经历疾病进展，这可能导致关节置换手术。在本综述中，我们研究了PsA与骨科手术之间的关系，重点关注全髋关节置换术（THA）和全膝关节置换术（TKA）的风险和时间趋势、术后并发症的发生率以及这些手术在PsA中的有效性。纳入的研究表明，与普通人群相比，PsA患者接受THA和TKA的总体风险更高，但时间趋势显示近年来确诊患者的风险有所降低。急性并发症，如肾衰竭、中风和术后感染，在PsA患者中可能比THA和TKA后骨关节炎患者更常见。THA后，PsA患者、皮肤银屑病患者和骨关节炎患者在疼痛、功能或满意度方面未发现显著差异。我们综述的一个关键结论是，需要加强风湿病学家和骨科医生之间的合作，因为多学科评估对于改善接受骨科手术的PsA患者的治疗效果至关重要。
