Can joint deformation caused by rheumatoid arthritis be corrected by surgery? _ Rheumatoid arthritis

Patients with rheumatoid arthritis still can't control their condition after active and regular drug treatment or drug treatment. In order to prevent joint injury, correct deformity and improve the quality of life, surgery can be considered. However, surgery can't cure rheumatoid arthritis radically, so medication is still needed after surgery. Commonly used operations mainly include synovectomy, arthroplasty, soft tissue release or repair, joint fusion and so on. ① Synovectomy For patients in early stage (stage ⅰ and ⅱ), after active and regular medical treatment, joint swelling and pain still exist, and synovium is hypertrophy. X-ray shows that articular cartilage has been invaded, the condition is relatively stable, and the affected joints are relatively limited. Synovectomy should be considered to prevent further damage to articular cartilage, and regular drug treatment is still needed after synovectomy. ② Artificial joint replacement is a kind of operation to save joint deformity and relieve symptoms, among which hip joint and knee joint are the most common replacement joints in clinic. The success rate of more than ten years after operation is over 90%. This operation has a very clear therapeutic effect on relieving rheumatoid arthritis, joint pain, deformity and dysfunction, and improving the ability of daily living, especially for patients with severe joint injury in the middle and late stage who can't work and live normally because of pain, deformity and dysfunction. Elbow, wrist and shoulder joint are non-load-bearing joints. Most patients do not need joint replacement through synovectomy or other orthopedic operations and other joint motion compensation. For finger joint deformity, the cost of joint replacement is high because there are many joints. ③ Other soft tissue operations are caused by rheumatoid arthritis. Besides bone deformity and intra-articular adhesion, atrophy of joint capsule and surrounding muscles and tendons is also one of the causes of joint deformity. Therefore, in order to alleviate the atrophy of joint capsule and its surrounding muscles and tendons, and thus correct joint deformity, soft tissue release can be done, including joint capsule peeling, joint capsule incision, tendon release or extension. Tendon surgery is the most widely used in hand, and soft tissue release is often needed to correct deformity when artificial joint replacement is carried out. Soft tissue release is often used to cut off adductor muscle when adduction deformity of hip joint, so as to improve joint mobility and correct adduction deformity, and it can also be used for early correction of deformity in some juvenile rheumatoid arthritis patients. Carpal tunnel syndrome is often treated by incision and decompression of transverse carpal ligament. Bursitis is found in the shoulder and hip joints of rheumatoid arthritis. If conservative treatment fails, surgical resection is often needed. Popliteal cyst is common in all kinds of knee arthritis, especially rheumatoid arthritis. After the primary disease is relieved, it often subsides on its own and occasionally requires surgery. Rheumatoid nodules are generally found in the active stage of the disease and rarely need surgical resection. Only the nodules are large and have pain symptoms, and those who are ineffective in conservative treatment need surgical resection. ④ Arthrodesis With the successful application of artificial joint replacement, arthrodesis has been rarely used in recent years.