Inflammatory at Rheumatoid Arthritis Impormasyon

Ang iyong nararamdaman

Ang inflammatory arthritis, kabilang ang rheumatoid arthritis, ay isang kondisyon kung saan inaatake ng iyong immune system ang lining ng iyong mga kasukasuan. Nagdudulot ito ng pamamaga, sakit, at paninigas, na madalas ay nangyayari sa ilang kasukasuan nang sabay-sabay. Ang parehong proseso ng sakit ay maaaring makaapekto sa iyong balikat, siko, pulso, balakang, tuhod, o bukung-bukong.

Ang sakit ay may tendensiyang lumala sa umaga at maaaring mabawasan habang ikaw ay gumagalaw sa loob ng araw. Ang pahinga ay maaaring magpakalma sa isang flare, ngunit ang paninigas ay madalas na bumabalik pagkatapos maupo nang walang galaw sa loob ng ilang oras. Maraming tao ang nakapapansin na ang kanilang mga sintomas ay pabalik-balik, na may mga tahimik na panahon sa pagitan ng mga flare.

Habang naaapektuhan ng kondisyon ang iyong mga kasukasuan, ang mga pang-araw-araw na gawain ay maaaring maging mas mahirap. Ang pagpihit ng door handle, pagbuhat ng kettle, pagdadala ng pinamili, o pagbangon mula sa upuan ay maaaring mangailangan ng higit na pagsisikap kaysa dati. Ang paglalakad ng malalayong distansya ay maaaring maging hindi komportable kung ang iyong balakang, tuhod, o bukung-bukong ay apektado. Ang pagsusulat, pag-type, o paghawak ng maliliit na bagay ay maaaring maging mahirap kapag ang iyong pulso o siko ay apektado.

Maaari mo ring maramdaman ang mga epekto ng kondisyon lampas sa mga kasukasuan mismo. Ang pamumuhay na may patuloy na sakit at paninigas ay maaaring makaapekto sa iyong mood at energy levels, at ito naman ay maaaring magpabago sa tindi ng sakit na iyong nararamdaman araw-araw.

Kung ang iyong mga kasukasuan ay napudpod na sa paglipas ng panahon, ang joint replacement surgery ay maaaring magbawas ng sakit at magpahusay sa paggana ng kasukasuan. Nalalapat ito sa balikat, siko, pulso, balakang, tuhod, at bukung-bukong. Ang pagbawi ng paggalaw at ginhawa ay madalas na unti-unti sa halip na instant, at nabubuo ito mula sa kung nasaan ka bago ang operasyon.

Dahil ang inflammatory arthritis ay nakaaapekto sa iyong buong katawan pati na rin sa iyong mga kasukasuan, maaari itong magdala ng bahagyang mas mataas na pagkakataon ng mga komplikasyon pagkatapos ng surgery kaysa sa wear-and-tear arthritis lamang. Tatalakayin ito ng iyong doktor sa iyo, kasama na kung paano ang iyong iba pang mga gamot at kondisyong pangkalusugan ay kasama sa plano.

Ano ang aktwal na nangyayari

Sa isang malusog na joint, ang mga dulo ng mga buto ay nababalutan ng makinis na cartilage, isang madulas na cushion na nagpapahintulot sa mga surface na dumulas sa isa't isa. Ang isang manipis na lining sa paligid ng joint ay gumagawa ng fluid na nagpapanatili sa malayang paggalaw ng lahat, na katulad ng langis sa bisagra ng pinto.

Sa inflammatory arthritis, napagkakamalan ng iyong immune system ang lining na ito bilang isang bagay na nakakasama at inaatake ito. Ang lining ay namamagat at gumagawa ng sobrang fluid, kaya ang joint ay lumalaki at nagiging stiff. Sa paglipas ng panahon, ang patuloy na inflammation ay kinakain ang cartilage cushion at maaari ring magpahina sa mga tendon, ang mga cord na nag-uugnay sa muscle sa buto. Ito ang dahilan kung bakit stiff ang iyong mga joint sa umaga, kung bakit ang mga flare ay pumupunta at nawawala, at kung bakit ang paghawak o paglalakad ay nagiging mas mahirap habang gumagaspang ang mga surface ng joint.

Dahil ang sakit ay nakakaapekto sa iyong buong katawan sa halip na sa isang pudpod na joint lamang, maaari itong makaapekto sa ilang joints nang sabay-sabay at maaari ring makaapekto sa lakas ng iyong buto at sa iyong tugon sa mga impeksyon. Ito ang dahilan kung bakit ang surgery sa isang inflamed joint ay may bahagyang mas mataas na pagkakataon ng mga komplikasyon kaysa sa surgery para sa wear-and-tear arthritis lamang, at kung bakit sinusuring mabuti ng iyong doktor ang iyong mga gamot at pangkalahatang kalusugan bago magrekomenda ng operasyon.

Kapag ang joint ay malubhang damaged, ang joint replacement surgery ay makakatulong. Ang pagpapalit ng mga pudpod na surface ng isang artificial joint ay nag-aalis ng masakit na friction. Ang mga taong may rheumatoid arthritis na sumailalim sa pagpapalit ng hip, knee o shoulder ay karaniwang nag-uulat ng mas kaunting sakit at mas mabuting function pagkatapos, katulad ng mga taong may wear-and-tear arthritis.

Ano ang maaari nating gawin tungkol dito

Marami kang maaaring gawin sa iyong sarili. Ang banayad at regular na ehersisyo ay nagpapanatili sa paggalaw ng iyong mga kasukasuan at nagpoprotekta sa iyong puso at pangkalahatang kalusugan. Ang supervised high-intensity interval training at strength exercise ay posible at maayos na natatanggap ng mga taong may well-controlled rheumatoid arthritis, kaya maaari itong irekomenda upang mapabuti ang cardiovascular at pisikal na kalusugan. Ang physical at occupational therapy ay maaari ring tumulong sa iyo sa pamamahala ng mga pang-araw-araw na gawain. Ang mga pamamaraang ito ay nararapat bigyan ng sapat na pagkakataon sa loob ng ilang linggo bago husgahan kung epektibo ang mga ito para sa iyo.

Ang mga gamot ang gumagawa ng mabigat na trabaho sa maagang yugto ng rheumatoid arthritis. Ang mga anti-inflammatory medicine at corticosteroid ay nagpapahupa ng sakit at pamamaga. Ang Methotrexate at biologic agents ay nagpapakalma sa immune system na umatake sa iyong mga kasukasuan. Ang biologic agents ay mga laboratory-made protein na karaniwang tina-target ang isang inflammatory messenger na tinatawag na tumour necrosis factor, at nagpakita ang mga ito ng mahusay na resulta sa paggamot. Dahil pinahihina nito ang iyong immune system, may dala itong mas mataas na panganib ng impeksyon, kaya ang trade-off na ito ay kailangang timbangin kasama ang iyong doktor. Ang modernong medical management ay nakagawa ng tunay na pagkakaiba: ang bilang ng mga joint replacement na isinagawa para sa rheumatoid arthritis ay bumaba ng 48% sa pagitan ng 1995 at 2010, na ibinatay sa pagiging epektibo ng pinabuting medical management.

Kung nananatiling malala ang iyong mga sintomas sa kabila ng mga paggamot na ito, maaaring i-refer ka ng iyong doktor para sa specialist assessment. Susuriing mabuti ng iyong doktor ang iyong mga gamot at pangkalahatang kalusugan, dahil ang ilang gamot ay kailangang itigil pansamantala bago ang operasyon. Ang mga immune-system-suppressing agent ay karaniwang hindi ibinibigay nang hindi bababa sa 1 linggo bago at 1 linggo pagkatapos ng operasyon, at ang mga taong gumagamit ng corticosteroid ay karaniwang nangangailangan ng mga karagdagang dosis ng hydrocortisone sa panahon ng operasyon. Para sa ilang tao na may malalang pinsala sa mga kasukasuan, maaaring isaalang-alang ang isang procedure paminsan-minsan.

Ano ang dapat asahan

Ang rheumatoid arthritis ay isang long-term condition, at para sa karamihan ng mga tao, ito ay pabalik-balik. May mga tahimik na panahon sa pagitan ng mga flare, at ang pamamaga at paninigas ay may tendensiyang lumala at humupa sa halip na mawala nang tuluyan. Dahil naaapektuhan nito ang iyong buong katawan, ilang mga joint ang maaaring madamay nang sabay-sabay, bagaman ang maliliit na joint ng iyong mga kamay at paa ang pinakamadalas maapektuhan.

Kung walang gamutan, ang pamamaga ay patuloy na sumisira sa iyong mga joint. Ang pinsala sa joint ay karaniwang nagsisimula sa loob ng una o ikalawang taon at nagpapatuloy mula roon. Sa paglipas ng panahon, lumalabas ito bilang sakit kapag ginagamit ang joint, at ang mga joint ay maaaring dahan-dahang magbago ng hugis. Mahalaga ang maagang gamutan dahil dito: ang mga gamot na sinimulan nang maaga ay maaaring magpakalma sa pamamaga bago pa nito mapudpod ang mga surface ng joint.

Sa maayos na pamamahala ng gamutan, iba ang magiging outlook. Ang mga modernong gamot ay maaaring magpahupa sa pamamaga at magpabagal o pumigil sa karagdagang pinsala, at maraming tao ang nananatiling komportableng aktibo sa loob ng maraming taon. Ang ilang tao ay nakakaabot sa estado kung saan tahimik ang kanilang sakit, na tinatawag ng mga doktor na remission. Kung ang isang joint ay malala na ang pinsala, ang joint replacement surgery ay maaari pa ring magbawas ng sakit at magpahusay sa paggana ng joint, katulad ng ginagawa nito para sa wear-and-tear arthritis.

Katotohanan na ang mga resulta pagkatapos ng surgery ay nag-iiba depende sa joint. Pagkatapos ng hip replacement, ang mga taong may rheumatoid arthritis ay karaniwang nag-uulat ng mas kaunting sakit at mas mabuting function, katulad ng mga taong may wear-and-tear arthritis, bagaman may medyo mas mataas na pagkakataon ng mga komplikasyon o karagdagang surgery sa hinaharap. Pagkatapos ng ankle replacement, ang mga taong may rheumatoid arthritis ay may tendensiyang mag-ulat ng mas kaunting pagbuti sa mga day-to-day score kaysa sa mga taong may ibang uri ng arthritis, ngunit bumubuti pa rin sila kumpara sa kung saan sila nagsimula. Ang wrist replacement ay nagpakita ng mabubuting resulta na tumatagal ng 10 taon pagkatapos ng surgery. Tatalakayin ng iyong doktor kung ano ang ibig sabihin nito para sa iyong partikular na joint.

Anuman ang joint, ang makatotohanang larawan ay unti-unting pag-unlad sa loob ng mga linggo at buwan sa halip na isang overnight fix, na nakabase sa matatag na medical care, pagpapanatiling gumagalaw ng iyong mga joint, at surgery kung saan ito ay tunay na kinakailangan.

Kailan dapat magpatingin

Ang inflammatory arthritis ay isang kondisyon na pinamamahalaan ng iyong GP at rheumatology team sa araw-araw, kaya karamihan ng iyong mga appointment ay kasama sila. Humingi ng specialist review kung ang isang kasukasuan ay nananatiling masakit, namamagà, o matigas sa kabila ng mga gamot na iyong iniinom, o kung ang isang kasukasuan ay nagbago ng hugis o nagpapahirap nang husto sa mga pang-araw-araw na gawain. Maaari ring ayusin ng iyong GP ang mga pagsusuri kung gaano kaepektibo ang iyong kasalukuyang gamutan.

Magpatingin agad sa iyong GP kung makaranas ng init, pamumula, o pamamaga sa isang kasukasuan na mas masakit kaysa sa iyong mga karaniwang flare, lalo na kung nakakaramdam ka ng lagnat o hindi mabuti ang pakiramdam. Ang isang namamagàng kasukasuan ay maaari kung minsan na magkaroon ng impeksyon, at nangangailangan ito ng pagsusuri nang walang pagkaantala.

Pumunta sa emergency department kung ikaw ay may mainit at sobrang sakit na kasukasuan na may kasamang lagnat at hindi ka makakuha ng urgent GP care, o kung sa pangkalahatan ay hindi mabuti ang iyong pakiramdam na may kasamang kumakalat na pamumula sa paligid ng kasukasuan.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

The volume of total joint arthroplasty procedures in patients with rheumatoid arthritis has trended markedly upward over the past decade, with a sharp increase after 2015 [1].
Inflammatory arthritis is associated with higher rates of medical and surgical complications compared to osteoarthritis in patients undergoing anatomic or reverse total shoulder arthroplasty [9].
Following total shoulder arthroplasty, patients with rheumatoid arthritis are at higher risk of systemic and joint-related complications compared to patients with primary osteoarthritis [5].
Despite comparable complication rates between rheumatoid arthritis and non-rheumatoid arthritis cohorts, rheumatoid arthritis patients have increased revision rates in total elbow arthroplasty [2].
Following primary total hip arthroplasty, patients with rheumatoid arthritis can expect reduced pain and improved functional outcomes similar to those with osteoarthritis [6].
Patients with rheumatoid arthritis undergoing primary total hip arthroplasty may be at an increased risk of complications and revision surgery [6].
In the largest single-institution study to date, patients with rheumatoid arthritis reported poorer patient-reported outcome scores compared with osteoarthritis and posttraumatic arthritis groups after total ankle arthroplasty [7].
Patients with rheumatoid arthritis experienced functional outcome improvement from the preoperative baseline following total ankle arthroplasty [7].
Denosumab demonstrates promising efficacy in maintaining bone health and preventing joint damage in rheumatoid arthritis patients with coexisting osteoporosis [3].
Cutaneous psoriasis and psoriatic arthritis are associated with higher rates of infections and all-cause revisions following total hip arthroplasty [13].

Background & Causes

Patients with rheumatoid arthritis undergoing elective hand surgery who continue perioperative biologic disease-modifying antirheumatic drugs do not experience significant increases in risks of wound healing failures or surgical site infections [15].
Discontinuation of antiviral prophylaxis correlates with a high prevalence of hepatitis B virus reactivation in rheumatoid arthritis patients with a hepatitis B virus carrier state [17].
Preclinical evidence supports an antioxidant, anti-inflammatory, antinociceptive, cartilage- and bone-protective effect of calcitonin in rheumatoid arthritis and osteoarthritis [16].
Tectochrysin may act as a novel rheumatoid arthritis therapeutic agent via macrophage JAK/STAT pathway inhibition [14].

Symptoms & Presentation

Patients with rheumatoid arthritis who have undergone shoulder arthroplasty experience reduced pain and improved function [10].
In patients with rheumatoid arthritis, negative affect moderates pain following shoulder arthroplasty [10].
Patients with rheumatoid arthritis report poorer patient-reported outcome scores compared with osteoarthritis and posttraumatic arthritis groups following total ankle arthroplasty [7].
Patients with rheumatoid arthritis experience functional outcome improvement from the preoperative baseline following total ankle arthroplasty [7].
Total knee arthroplasty in patients with rheumatoid arthritis yields significant improvement in physician- and patient-reported outcomes [12].
Patients with rheumatoid arthritis can expect reduced pain and improved functional outcomes similar to those with osteoarthritis following primary total hip arthroplasty [6].
Patient-reported functional outcomes at 6 months following total elbow arthroplasty were significantly lower in the fracture group compared to osteoarthritis and rheumatoid arthritis groups [11].
The Kudo type-5 prosthesis demonstrated satisfactory results in patients with rheumatoid arthritis over a minimum 10-year follow-up period [18].
Failures of the Kudo type-5 prosthesis occurred to some extent over a long-term follow-up period in patients with rheumatoid arthritis [18].
HandScan optical imaging can reliably identify ultrasound-defined remission in rheumatoid arthritis at the joint level with good sensitivity and high positive predictive value [21].
DAS-OST can determine ultrasound remission in rheumatoid arthritis at the patient level but with lower performance than HandScan [21].

Management

Non-Operative

Rheumatoid arthritis is a chronic, systemic, inflammatory disease that most often involves the small joints of the hands and feet, although any synovial joint can be affected [19].
Rheumatoid arthritis affects 1% to 2% of the world population, with a female-to-male ratio of 2.5:1 [19].
Adult rheumatoid arthritis is usually polyarticular, while systemic involvement in visceral organs or eyes is rare [19].
The test for rheumatoid factor in adults is positive in 70% to 80% of patients diagnosed with rheumatoid arthritis [19].
A patient is considered to have rheumatoid arthritis if at least four of the seven American Rheumatism Association criteria have been present for at least 6 weeks [19].
The clinical picture of rheumatoid arthritis is characterized by synovitis and joint destruction, with synovitis tending to wax and wane [19].
Joint destruction in rheumatoid arthritis starts within the first or second year of the disease and continues to progress [19].
Radiographic signs of rheumatoid arthritis destruction include joint space narrowing, periarticular erosions, and subchondral osteopenia [19].
Structural damage in rheumatoid arthritis manifests as pain with activity and deformity [19].
Treatment of the early stages of rheumatoid arthritis is primarily medical, although physical and occupational therapy can be helpful [19].
Pharmacologic agents used in rheumatoid arthritis include nonsteroidal antiinflammatory drugs, corticosteroids, methotrexate, and biologic agents [19].
Biologic agents are recombinant proteins that generally target an inflammatory cytokine, such as tumor necrosis factor [19].
Biologic agents have shown excellent results in rheumatoid arthritis treatment [19].
Biologic agents inhibit the immune system and cause an increased risk of infection in patients taking them [19].
Jämsen et al. found a 48% decrease in the number of primary arthroplasties performed for rheumatoid arthritis between 1995 and 2010, attributed to the effectiveness of improved medical management [19].
There is preclinical evidence for an antioxidant, anti-inflammatory, antinociceptive, cartilage- and bone-protective effect of calcitonin in rheumatoid arthritis and osteoarthritis [16].
Tectochrysin may be a novel rheumatoid arthritis therapeutic agent acting via macrophage JAK/STAT pathway inhibition, with promising clinical potential [14].
Supervised high-intensity interval training and strength exercise appear to be feasible and well tolerated by patients and could be recommended to improve cardiovascular and physical health in patients with well-controlled rheumatoid arthritis [20].

Perioperative Medical Management

Patients with rheumatoid arthritis on corticosteroids generally require preoperative “stress” dosages of hydrocortisone [19].
Agents that inhibit the immune system should be withheld at least 1 week before and 1 week after a surgical procedure in patients with rheumatoid arthritis [19].
Among patients with rheumatoid arthritis undergoing elective hand surgery, perioperative biologic disease-modifying antirheumatic drug continuation was not associated with significant increases in risks of wound healing failures or surgical site infections [15].

Operative

The volume of total joint arthroplasty procedures conducted in patients with rheumatoid arthritis has trended markedly upward over the past decade, with a sharp increase after 2015 [1].
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 total hip arthroplasty [6].
Following total shoulder arthroplasty, patients with rheumatoid arthritis should be considered at higher risk of systemic and joint-related complications compared to patients with primary osteoarthritis [5].
Shoulder arthroplasty in patients with rheumatoid arthritis reduces pain and improves function [10].
In the largest single-institution study to date, patients with rheumatoid arthritis reported poorer patient-reported outcome scores compared with osteoarthritis and posttraumatic arthritis groups but experienced functional outcome improvement from the preoperative baseline following total ankle arthroplasty [7].
Despite comparable complication rates between rheumatoid arthritis and non-rheumatoid arthritis cohorts, further investigation into the underlying mechanisms of increased revision rates in rheumatoid arthritis patients is warranted following total elbow arthroplasty [2].
Patient-reported functional outcomes at 6 months were significantly lower in the fracture group compared to osteoarthritis and rheumatoid arthritis groups following total elbow arthroplasty [11].
Comparative outcomes of robot-assisted versus conventional total knee arthroplasty provide important evidence for selecting surgical methods in rheumatoid osteoarthritis [4].

Key Considerations

Epidemiology and Trends

Perioperative Risk and Complications

Patients with rheumatoid arthritis may be at an increased risk of complications and revision surgery following primary total hip arthroplasty [6].
Despite comparable complication rates between rheumatoid arthritis and non-RA cohorts in total elbow arthroplasty, further investigation into the underlying mechanisms of increased revision rates in RA patients is warranted [2].

Functional Outcomes and Patient-Reported Measures

In the largest single-institution study to date, patients with rheumatoid arthritis reported poorer patient-reported outcome scores compared with osteoarthritis and posttraumatic arthritis groups following total ankle arthroplasty [7].

Long-Term Survivorship and Device Performance

The Kudo type-5 prosthesis demonstrated satisfactory results in patients with rheumatoid arthritis, although failures occurred to some extent over a long-term follow-up period [18].
Radiolunate arthrodesis in patients with rheumatoid arthritis maintained good clinical results and corrected alignment during long-term follow-up [22].

Surgical Technique Selection

Patient Education

Physicians should provide information regarding the treatment of rheumatoid arthritis to patients in counseling and education materials [8].

Pharmacologic Management

Key Evidence

[L4] The volume of total joint arthroplasty (TJA) procedures conducted in patients with rheumatoid arthritis has trended markedly upward over the past decade, with a sharp increase after 2015. [1] (10.5435/jaaosglobal-d-22-00209)
[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. [2] (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. [3] (10.1186/s12891-025-08688-8)
[L3] This provides important evidence for selecting surgical methods in rheumatoid osteoarthritis. [4] (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. [5] (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. [6] (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. [7] (10.2106/jbjs.24.00048)
[L4] Physicians should provide such information to patients with RA in the counseling and education materials. [8] (10.1371/journal.pone.0285869)
[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. [9] (10.1016/j.jse.2023.09.014)
[L3] Shoulder arthroplasty in patients with rheumatoid arthritis reduces pain and improves function. [10] (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. [11] (10.1016/j.jse.2026.01.019)
[L3] Total knee arthroplasty in patients who have RA yields significant improvement in physician- and patient-reported outcomes. [12] (10.1016/j.arth.2026.03.021)
[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)
[L5] Tectochrysin may be a novel RA therapeutic agent, likely acting via macrophage JAK/STAT pathway inhibition, with promising clinical potential. [14] (10.1186/s13018-025-06481-w)
[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. [15] (10.1016/j.jhsa.2026.03.003)
[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] Discontinuation of antiviral prophylaxis correlates with high prevalence of hepatitis B virus (HBV) reactivation in rheumatoid arthritis patients with HBV carrier state. [17] (10.1186/1471-2474-15-449)
[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. [18] (10.1016/j.jse.2024.10.025)
[L1] Supervised HIIT and strength exercise appear to be feasible and well tolerated by patients and could be recommended to improve cardiovascular and physical health in patients with well-controlled RA. [20] (10.1136/bjsports-2024-108369)
[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. [21] (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. [22] (10.1016/j.jhsa.2022.11.014)

References

[1] Trends in Total Joint Arthroplasty Among Patients With Rheumatoid Arthritis: The Effect of Recent Disease Modifying Antirheumatic Drug Utilization Guidelines. JAAOS: Global Research and Reviews. 2022. DOI: 10.5435/jaaosglobal-d-22-00209

[2] 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

[3] 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

[4] 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

[5] 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

[6] 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

[7] 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

[8] 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

[9] 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

[10] 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

[11] 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

[12] 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

[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] 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

[15] 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

[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] Discontinuation of antiviral prophylaxis correlates with high prevalence of hepatitis B virus (HBV) reactivation in rheumatoid arthritis patients with HBV carrier state: a real-world clinical practice. BMC Musculoskeletal Disorders. 2014. DOI: 10.1186/1471-2474-15-449

[18] 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

[19] Campbell S Operative Orthopaedics 4 Volume Set. SOFT-TISSUE PROCEDURES AND OSTEOTOMIES ABOUT THE KNEE > RHEUMATOID ARTHRITIS OF THE KNEE > ADULT-ONSET RHEUMATOID ARTHRITIS.

[20] High-intensity interval training improves cardiovascular and physical health in patients with rheumatoid arthritis: a multicentre randomised controlled trial. British Journal of Sports Medicine. 2024. DOI: 10.1136/bjsports-2024-108369

[21] Optical imaging (HandScan) can identify ultrasound remission in rheumatoid arthritis. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-07472-4

[22] 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