Inflammatory and Rheumatoid Arthritis Info Evidence
Reviewed by Dr Kieran Hirpara, Specialist Orthopaedic Surgeon Last reviewed
What you're feeling
You may notice that your joints feel stiff and swollen, particularly in your hands and wrists. This stiffness is often most noticeable when you first wake up in the morning. It can make simple tasks, like opening a jar or turning a key, feel difficult and painful. The pain might also flare up after you have been using your hands for a while, such as during typing or cooking.
In some cases, you might experience swelling around your ankle. This can cause intermittent pain that comes and goes over months or even years. Because the symptoms are not always constant, it can be easy to overlook the issue until it becomes more persistent. You might find that walking or standing for long periods aggravates this discomfort.
If you are considering joint replacement surgery, it is important to understand that rheumatoid arthritis affects your body differently than wear-and-tear arthritis. Your doctor will explain that inflammatory conditions can increase the risk of complications after surgery, such as total hip or knee replacement. For example, patients with rheumatoid arthritis may face a higher risk of medical issues in the first 90 days after shoulder surgery compared to those with standard osteoarthritis.
Despite these risks, many patients still see significant benefits. You can expect reduced pain and improved function after hip or knee replacement, similar to what others experience. However, outcomes for ankle replacement may vary, with some patients reporting less improvement than those with other types of arthritis. Your doctor will review your specific case to help you understand what to expect based on your unique health profile.
What's actually happening
Rheumatoid arthritis is an autoimmune condition. Your immune system mistakenly attacks the lining of your joints. This lining is called the synovium. In a healthy joint, this layer is thin and smooth. In rheumatoid arthritis, it becomes thick and inflamed. Think of it like a gasket that has swollen and lost its shape.
This swelling causes pain and stiffness. The inflamed tissue releases enzymes that damage the cartilage. Cartilage is the smooth, shock-absorbing coating on the ends of your bones. As this coating wears away, your bones begin to rub against each other. This friction causes further damage to the joint structure. Over time, this can lead to bone erosion and joint deformity.
Because the disease affects your whole body, it changes how your body handles surgery. Your doctor notes that rheumatoid arthritis carries a higher risk of complications compared to wear-and-tear arthritis. This includes a higher rate of systemic issues in the first 90 days after shoulder replacement. It also means a higher chance of needing revision surgery for hips and elbows.
Despite these risks, many patients still benefit significantly. For example, hip replacement patients with rheumatoid arthritis often see pain relief and function improve just like those with osteoarthritis. Knee replacements also provide substantial improvement in daily function. However, ankle replacements may not restore function as well in this group.
Your care team manages these risks carefully. We monitor your bone health closely, as rheumatoid arthritis often weakens bones. We may adjust your medications to keep the disease quiet during surgery. This helps protect your healing tissues and reduces infection risk. Understanding these underlying changes helps us plan your treatment safely.
What we can do about it
We start with self-management. Gentle exercise and physiotherapy help keep your joints moving and strong. This routine aims to reduce stiffness and maintain your daily function. Give these methods a fair trial over several weeks. Consistent movement is key to managing the wear-and-tear on your joints.
Medical management focuses on controlling inflammation and pain. Your doctor may prescribe anti-inflammatory medications to ease swelling and discomfort. For some patients, hormone therapy is considered to manage symptoms, though it carries specific trade-offs that we discuss with you. If you have osteoporosis alongside rheumatoid arthritis, treatments like denosumab can help maintain bone health and prevent joint damage. We also review your current medications, such as biologic disease-modifying antirheumatic drugs, to ensure they support your surgery without increasing risks like wound healing issues or infections.
If symptoms remain severe despite these steps, we may refer you for specialist assessment. In some cases, a procedure may be considered to restore function. For example, total hip arthroplasty (joint replacement) can provide reduced pain and improved function similar to those with primary osteoarthritis. Total knee arthroplasty also yields significant improvement in both physician-reported and patient-reported outcomes. However, we note that inflammatory arthritis can present a higher risk profile for complications compared to non-inflammatory conditions. Total elbow arthroplasty may have higher long-term revision rates in rheumatoid arthritis patients. Total shoulder arthroplasty is associated with higher rates of medical and surgical complications. Total ankle arthroplasty may result in poorer outcome scores compared to other arthritis types, though functional improvement is still possible. We tailor our approach to your specific needs and risks.
What to expect
Your outlook depends on which joint is affected and the type of arthritis you have. Rheumatoid arthritis is a long-term condition that causes inflammation in your joints. Without treatment, this inflammation can lead to ongoing pain, stiffness, and joint damage over time. When managed well with medication and surgery, most people see significant relief from pain and better movement.
For hip replacements, you can expect pain relief and improved function similar to patients with wear-and-tear arthritis. Your doctor will aim for outcomes that match those seen in non-inflammatory cases. Knee replacements also tend to bring significant improvement in both how you feel and how your doctor assesses your knee. You may notice better mobility and less discomfort in daily activities.
Shoulder replacements often reduce pain and improve function. However, because rheumatoid arthritis affects your whole body, you face a higher risk of medical complications in the first 90 days after surgery compared to those with simple wear-and-tear arthritis. Your care team will monitor you closely for these systemic issues.
Elbow replacements generally have similar complication rates to non-rheumatoid cases, but they may require revision surgery more often in the long term. Ankle replacements improve function from your starting point, but patient-reported scores are often lower than those for wear-and-tear or post-injury cases. Wrist procedures can maintain good alignment and clinical results over many years.
Hand surgery is another area where you might seek help. Continuing certain biologic medications around the time of elective hand surgery does not significantly increase the risk of wound healing problems or infections. This allows your rheumatologist and doctor to coordinate your care safely.
Overall, surgery can restore function and reduce pain. But because your body’s inflammatory response is active, you must be aware of higher risks for shoulder and elbow procedures. Your doctor will tailor your plan to manage these risks while maximizing your benefit.
When to see someone
See your GP if you have persistent joint pain that does not improve with rest. Ask for a specialist review if you notice weakness, instability, or if your joints lock or give way. Seek urgent care if symptoms interfere with your sleep or work, or if you experience a sudden worsening of pain. Chronic inflammation can cause swelling in areas like the ankle that may go unnoticed for months. Early assessment helps manage these changes. Your doctor can guide you on the best next steps for your specific symptoms.
Evidence & references
Overview
- Total elbow arthroplasty in patients with rheumatoid arthritis is associated with increased revision rates compared to non-RA cohorts, despite comparable complication rates [1].
- Denosumab demonstrates efficacy in maintaining bone health and preventing joint damage in rheumatoid arthritis patients with coexisting osteoporosis [2].
- Robot-assisted total knee arthroplasty provides evidence for selecting surgical methods in rheumatoid osteoarthritis compared to conventional techniques [3].
- Rheumatoid arthritis is associated with higher 90-day systemic complications compared to osteoarthritis after total shoulder arthroplasty [4].
- Patients with rheumatoid arthritis are at higher risk of systemic and joint-related complications following total shoulder arthroplasty compared to patients with primary osteoarthritis [4].
- Patient-reported outcome measures after direct anterior total hip arthroplasty are comparable between patients with rheumatoid arthritis and osteoarthritis [5].
- Patients with rheumatoid arthritis can expect reduced pain and improved functional outcomes similar to those with osteoarthritis following primary total hip arthroplasty [5].
- Patients with rheumatoid arthritis may be at an increased risk of complications and revision surgery following total hip arthroplasty [5].
- Patients with rheumatoid arthritis reported poorer patient-reported outcome scores compared with osteoarthritis and posttraumatic arthritis groups after total ankle arthroplasty [6].
- Patients with rheumatoid arthritis experienced functional outcome improvement from the preoperative baseline after total ankle arthroplasty [6].
- Shoulder arthroplasty for inflammatory arthritis is associated with higher rates of medical and surgical complications compared to osteoarthritis [7].
- Inflammatory arthritis represents a distinctly morbid risk profile with multiple increased surgical and postoperative medical complications in patients undergoing anatomic and reverse total shoulder arthroplasty [7].
- Total knee arthroplasty in patients with rheumatoid arthritis yields significant improvement in physician- and patient-reported outcomes [8].
- Cutaneous psoriasis and psoriatic arthritis are associated with higher rates of infections and all-cause revisions following total hip arthroplasty [13].
Background & Causes
- Rheumatoid arthritis is associated with higher 90-day systemic complications compared to osteoarthritis after total shoulder arthroplasty [4].
- Inflammatory arthritis represents a distinctly morbid risk profile compared to osteoarthritis patients with multiple increased surgical and postoperative medical complications in patients undergoing aTSA and rTSA [7].
- Patients with rheumatoid arthritis may be at an increased risk of complications and revision surgery following primary total hip arthroplasty [5].
- Rates of long-term risk of revision in total elbow arthroplasty are increased in patients with rheumatoid arthritis compared to non-RA cohorts [1].
- Denosumab demonstrates efficacy in maintaining bone health and preventing joint damage in rheumatoid arthritis patients with coexisting osteoporosis [2].
- Denosumab reduced joint mTSS, JSN, and BES, alleviated joint space narrowing, and inhibited bone erosion in rheumatoid arthritis patients [21].
- Perioperative bDMARD continuation was not associated with significant increases in risks of wound healing failures or SSIs among patients with RA undergoing elective hand surgery [10].
- Shoulder arthroplasty in patients with rheumatoid arthritis reduces pain and improves function [11].
- Patients with RA reported poorer PRO scores compared with OA and posttraumatic arthritis groups after total ankle arthroplasty but experienced functional outcome improvement from the preoperative baseline [6].
- The Kudo type-5 prosthesis demonstrated satisfactory results in patients with RA but failures occurred to some extent over a long-term follow-up period [14].
- Tectochrysin may be a novel RA therapeutic agent, likely acting via macrophage JAK/STAT pathway inhibition, with promising clinical potential [15].
- There is preclinical evidence for an antioxidant, anti-inflammatory, antinociceptive, cartilage- and bone-protective effect of calcitonin in RA [16].
Symptoms & Presentation
- Internet search analysis reveals specific questions and reading behaviors regarding the treatment of rheumatoid arthritis among patients [9].
- HandScan optical imaging can reliably identify ultrasound-defined remission in rheumatoid arthritis at the joint level with good sensitivity and high positive predictive value [18].
- DAS-OST can determine ultrasound-defined remission at the patient level in rheumatoid arthritis, but with lower performance compared to joint-level identification [18].
- Chronic non-specific tenosynovitis with effusion localized at the ankle may present with intermittent symptoms that remain unrecognized for months or even years [17].
Management
- Total elbow arthroplasty in patients with rheumatoid arthritis is associated with higher long-term revision rates compared to non-RA cohorts, despite comparable complication rates [1].
- Denosumab demonstrates efficacy in maintaining bone health and preventing joint damage in rheumatoid arthritis patients with coexisting osteoporosis [2].
- Robot-assisted total knee arthroplasty provides evidence for surgical method selection in rheumatoid osteoarthritis [3].
- Rheumatoid arthritis is associated with higher 90-day systemic complications compared to osteoarthritis after total shoulder arthroplasty [4].
- Patients with rheumatoid arthritis undergoing total shoulder arthroplasty are at higher risk of systemic and joint-related complications compared to patients with primary osteoarthritis [4].
- Patient-reported outcome measures after direct anterior total hip arthroplasty are comparable between patients with rheumatoid arthritis and osteoarthritis [5].
- Patients with rheumatoid arthritis can expect reduced pain and improved functional outcomes similar to those with osteoarthritis following primary total hip arthroplasty [5].
- Patients with rheumatoid arthritis undergoing total ankle arthroplasty reported poorer patient-reported outcome scores compared with osteoarthritis and posttraumatic arthritis groups [6].
- Patients with rheumatoid arthritis undergoing total ankle arthroplasty experienced functional outcome improvement from the preoperative baseline [6].
- Shoulder arthroplasty for inflammatory arthritis is associated with higher rates of medical and surgical complications compared to osteoarthritis [7].
- Inflammatory arthritis represents a distinctly morbid risk profile with multiple increased surgical and postoperative medical complications in patients undergoing anatomic and reverse total shoulder arthroplasty [7].
- Total knee arthroplasty in patients with rheumatoid arthritis yields significant improvement in physician-reported outcomes [8].
- Total knee arthroplasty in patients with rheumatoid arthritis yields significant improvement in patient-reported outcomes [8].
- Physicians should provide internet search-derived information on rheumatoid arthritis treatment to patients in counseling and education materials [9].
- Perioperative biologic disease-modifying antirheumatic drug continuation in patients with rheumatoid arthritis undergoing elective hand surgery was not associated with significant increases in risks of wound healing failures or surgical site infections [10].
- Shoulder arthroplasty in patients with rheumatoid arthritis reduces pain and improves function [11].
- Negative affect moderates pain in patients with rheumatoid arthritis who have undergone shoulder arthroplasty [11].
- Patient-reported functional outcomes at 6 months after total elbow arthroplasty were significantly lower in the fracture group compared to osteoarthritis and rheumatoid arthritis groups [12].
- Targeting macrophage JAK3/STAT3 signaling with tectochrysin ameliorates bone erosion and synovitis in rheumatoid arthritis [15].
- Tectochrysin acts via macrophage JAK/STAT pathway inhibition and has promising clinical potential as a novel rheumatoid arthritis therapeutic agent [15].
- Preclinical evidence supports an antioxidant, anti-inflammatory, antinociceptive, cartilage-protective, and bone-protective effect of calcitonin in rheumatoid arthritis [16].
Key Considerations
- Total elbow arthroplasty in patients with rheumatoid arthritis has comparable complication rates to non-RA cohorts [1].
- Total elbow arthroplasty in patients with rheumatoid arthritis is associated with increased revision rates compared to non-RA cohorts [1].
- Denosumab demonstrates efficacy in maintaining bone health and preventing joint damage in rheumatoid arthritis patients with coexisting osteoporosis [2].
- Robot-assisted total knee arthroplasty provides evidence for selecting surgical methods in rheumatoid osteoarthritis [3].
- Rheumatoid arthritis is associated with higher 90-day systemic complications compared to osteoarthritis after total shoulder arthroplasty [4].
- Patients with rheumatoid arthritis are at higher risk of systemic and joint-related complications following total shoulder arthroplasty compared to patients with primary osteoarthritis [4].
- Patient-reported outcome measures after direct anterior total hip arthroplasty are comparable between patients with rheumatoid arthritis and osteoarthritis [5].
- Patients with rheumatoid arthritis may be at increased risk of complications and revision surgery following total hip arthroplasty [5].
- Patients with rheumatoid arthritis can expect reduced pain and improved functional outcomes similar to those with osteoarthritis following primary total hip arthroplasty [5].
- Patients with rheumatoid arthritis reported poorer patient-reported outcome scores compared with osteoarthritis and posttraumatic arthritis groups after total ankle arthroplasty [6].
- Patients with rheumatoid arthritis experienced functional outcome improvement from the preoperative baseline after total ankle arthroplasty [6].
- Total knee arthroplasty in patients with rheumatoid arthritis yields significant improvement in physician-reported outcomes [8].
- Total knee arthroplasty in patients with rheumatoid arthritis yields significant improvement in patient-reported outcomes [8].
- Physicians should provide information on internet search trends regarding rheumatoid arthritis treatment to patients in counseling and education materials [9].
- Perioperative biologic disease-modifying antirheumatic drug continuation was not associated with significant increases in risks of wound healing failures or surgical site infections among patients with rheumatoid arthritis undergoing elective hand surgery [10].
- Patient-reported functional outcomes at 6 months after total elbow arthroplasty were significantly lower in the fracture group compared to osteoarthritis and rheumatoid arthritis groups [12].
- The Kudo type-5 prosthesis demonstrated satisfactory results in patients with rheumatoid arthritis over a minimum 10-year follow-up period [14].
- Failures of the Kudo type-5 prosthesis occurred to some extent over a long-term follow-up period in patients with rheumatoid arthritis [14].
- Radiolunate arthrodesis in patients with rheumatoid arthritis maintained good clinical results and corrected alignment during long-term follow-up [19].
- Total wrist arthroplasty using the semiconstrained arthroplasty system achieves favorable clinical outcomes with no serious complications requiring revision for 10 years after surgery in patients with rheumatoid arthritis [22].
Key Evidence
- [L3] Despite comparable complication rates between RA and non-RA cohorts, further investigation into the underlying mechanisms of increased revision rates in RA patients is warranted. [1] (10.1016/j.jse.2024.12.032)
- [L1] Denosumab demonstrates promising efficacy in maintaining bone health and preventing joint damage in rheumatoid arthritis patients with coexisting osteoporosis. [2] (10.1186/s12891-025-08688-8)
- [L3] This provides important evidence for selecting surgical methods in rheumatoid osteoarthritis. [3] (10.1186/s13018-026-06703-9)
- [L3] Following TSA, RA patients should be considered at higher risk of systemic and joint-related complications compared to patients with primary OA. [4] (10.5397/cise.2024.00374)
- [L3] Although patients with rheumatoid arthritis may be at an increased risk of complications and revision surgery, patients can expect reduced pain and improved functional outcomes similar to those with osteoarthritis following primary THA. [5] (10.5435/jaaos-d-24-00656)
- [L3] In the largest single-institution study to date, patients with RA reported poorer PRO scores compared with the OA and posttraumatic arthritis groups but experienced functional outcome improvement from the preoperative baseline. [6] (10.2106/jbjs.24.00048)
- [L3] Inflammatory arthritis represents a distinctly morbid risk profile compared to osteoarthritis patients with multiple increased surgical and postoperative medical complications in patients undergoing aTSA and rTSA. [7] (10.1016/j.jse.2023.09.014)
- [L3] Total knee arthroplasty in patients who have RA yields significant improvement in physician- and patient-reported outcomes. [8] (10.1016/j.arth.2026.03.021)
- [L4] Physicians should provide such information to patients with RA in the counseling and education materials. [9] (10.1371/journal.pone.0285869)
- [L2] Among patients with RA undergoing elective hand surgery, perioperative bDMARD continuation was not associated with significant increases in risks of wound healing failures or SSIs. [10] (10.1016/j.jhsa.2026.03.003)
- [L3] Shoulder arthroplasty in patients with rheumatoid arthritis reduces pain and improves function. [11] (10.1186/s13018-025-06109-z)
- [L3] Patient-reported functional outcomes at 6 months were significantly lower in the fracture group compared to osteoarthritis and rheumatoid arthritis groups. [12] (10.1016/j.jse.2026.01.019)
- [L3] In particular, both PsC and PsA were associated with higher rates of infections and all-cause revisions. [13] (10.1016/j.arth.2026.03.054)
- [L4] Although the Kudo type-5 prosthesis demonstrated satisfactory results in patients with RA, failures occurred to some extent over a long-term follow-up period. [14] (10.1016/j.jse.2024.10.025)
- [L5] Tectochrysin may be a novel RA therapeutic agent, likely acting via macrophage JAK/STAT pathway inhibition, with promising clinical potential. [15] (10.1186/s13018-025-06481-w)
- [L1] There is preclinical evidence for an antioxidant, anti-inflammatory, antinociceptive, cartilage- and bone-protective effect of CT in RA and OA. [16] (10.1530/eor-23-0133)
- [L4] In chronic non-specific tenosynovitis with effusion localized at the ankle, symptoms may be intermittent and the true nature of the condition may remain unrecognized for months or even years. [17] (10.2106/jbjs.25.00400)
- [L3] HandScan is able to reliably identify US-defined remission in RA at the joint level, with a good sensitivity and high PPV, while at the patient level, DAS-OST can also determine US remission but with lower performance. [18] (10.1186/s12891-024-07472-4)
- [L4] Radiolunate arthrodesis in patients with RA maintained good clinical results and corrected alignment, even during long-term follow-up. [19] (10.1016/j.jhsa.2022.11.014)
- [L1] Additionally, it reduced joint mTSS, JSN, and BES, alleviated joint space narrowing, and inhibited bone erosion, providing maximal joint protection and maintaining joint function. [21] (10.1186/s12891-025-09206-6)
- [L4] Total wrist arthroplasty using the semiconstrained arthroplasty system achieves favorable clinical outcomes with no serious complications requiring revision for 10 years after surgery. [22] (10.1016/j.jhsa.2024.03.002)
References
[1] Rates of long-term risk of revision and complications in total elbow arthroplasty in patients with rheumatoid arthritis: a propensity score-matched analysis. Journal of Shoulder and Elbow Surgery. 2025. DOI: 10.1016/j.jse.2024.12.032 [2] Efficacy of denosumab in treatment of osteoporosis in patients with rheumatoid arthritis: a meta-analysis of randomized controlled trial. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-08688-8 [3] Comparative outcomes of robot-assisted versus conventional TKA in rheumatoid arthritis patients. Journal of Orthopaedic Surgery and Research. 2026. DOI: 10.1186/s13018-026-06703-9 [4] Rheumatoid arthritis is associated with higher 90-day systemic complications compared to osteoarthritis after total shoulder arthroplasty: a cohort study. Clinics in Shoulder and Elbow. 2024. DOI: 10.5397/cise.2024.00374 [5] Patient-Reported Outcome Measures After Direct Anterior Total Hip Arthroplasty Are Comparable Between Patients With Rheumatoid Arthritis and Osteoarthritis: A Propensity-Matched Analysis. Journal of the American Academy of Orthopaedic Surgeons. 2024. DOI: 10.5435/jaaos-d-24-00656 [6] Complication Rates and Functional Outcomes After Total Ankle Arthroplasty in Patients with Rheumatoid Arthritis. Journal of Bone and Joint Surgery. 2025. DOI: 10.2106/jbjs.24.00048 [7] Shoulder arthroplasty for inflammatory arthritis is associated with higher rates of medical and surgical complications: a nationwide matched cohort analysis from 2016-2020. Journal of Shoulder and Elbow Surgery. 2024. DOI: 10.1016/j.jse.2023.09.014 [8] Patient-Reported Outcomes and Satisfaction Following Total Knee Arthroplasty in Rheumatoid Arthritis: An Observational Cohort Study. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.03.021 [9] Internet search analysis on the treatment of rheumatoid arthritis: What do people ask and read online?. PLOS ONE. 2023. DOI: 10.1371/journal.pone.0285869 [10] Perioperative Biologic Disease-Modifying Antirheumatic Drugs, Risks of Infections, and Wound Complications in Patients With Rheumatoid Arthritis Undergoing Elective Hand Surgery. The Journal of Hand Surgery. 2026. DOI: 10.1016/j.jhsa.2026.03.003 [11] The moderating role of negative affect on pain in patients with rheumatoid arthritis who have undergone shoulder arthroplasty. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06109-z [12] A comparison of survivorship and functional outcomes for total elbow arthroplasty performed for distal humerus fracture, rheumatoid arthritis, and osteoarthritis, a New Zealand Joint Registry study. Journal of Shoulder and Elbow Surgery. 2026. DOI: 10.1016/j.jse.2026.01.019 [13] Outcomes Following Total Hip Arthroplasty in Patients with Cutaneous Psoriasis and Psoriatic Arthritis. The Journal of Arthroplasty. 2026. DOI: 10.1016/j.arth.2026.03.054 [14] Long-term follow-up study of Kudo type-5 elbow prosthesis in patients with rheumatoid arthritis: minimum 10-year clinical outcomes. Journal of Shoulder and Elbow Surgery. 2025. DOI: 10.1016/j.jse.2024.10.025 [15] Targeting macrophage JAK3/STAT3 signaling with tectochrysin: a novel therapeutic strategy to ameliorate bone erosion and synovitis in rheumatoid arthritis. Journal of Orthopaedic Surgery and Research. 2025. DOI: 10.1186/s13018-025-06481-w [16] Calcitonin treatment for osteoarthritis and rheumatoid arthritis – a systematic review and meta-analysis of preclinical data. EFORT Open Reviews. 2024. DOI: 10.1530/eor-23-0133 [17] Complication Rates and Functional Outcomes After TAA in Patients with Rheumatoid Arthritis Are Less Defined Than for Patients with Osteoarthritis. Journal of Bone and Joint Surgery. 2025. DOI: 10.2106/jbjs.25.00400 [18] Optical imaging (HandScan) can identify ultrasound remission in rheumatoid arthritis. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-07472-4 [19] Radiolunate Arthrodesis in the Rheumatoid Wrist: A Retrospective Clinical and Radiologic Long-Term Follow-Up. The Journal of Hand Surgery. 2024. DOI: 10.1016/j.jhsa.2022.11.014 [21] Efficacy and safety of denosumab in treatment of osteoporosis in patients with rheumatoid arthritis: a meta-analysis and systematic review. BMC Musculoskeletal Disorders. 2025. DOI: 10.1186/s12891-025-09206-6 [22] Clinical Outcomes of Total Wrist Arthroplasty in Patients With Rheumatoid Arthritis: Minimum 10-Year Follow-Up Study. The Journal of Hand Surgery. 2025. DOI: 10.1016/j.jhsa.2024.03.002
