Pamamaga at Rheumatoid Arthritis Impormasyon

Ano ang nararamdaman mo

Maaaring mapansin mo ang sakit at pamamaga sa iyong mga kasukasuan, madalas sa iyong mga kamay, pulso, o paa. Ang hindi kagustuhan na ito ay maaaring maramdaman bilang isang malalim na pananakit o matulis na tusok. Maaari itong manatili sa isang partikular na lugar sa loob ng mga buwan o taon nang hindi mo alam ang dahilan. Maaari mong makita na ang ilang mga galaw ay nagiging mahirap. Ang pag-abot sa likod mo upang isara ang bra ay maaaring maramdaman na matigas. Ang pagtutukoy ng iyong shirt ay maaaring humila sa iyong mga gilid. Ang pag-angat ng mga bagay ay maaaring maramdaman na mas mabigat kaysa karaniwan.

Ang sakit ay madalas nagbabago sa loob ng araw. Maaari itong mas lalong lumala kapag gising ka pa lang sa umaga. Ang iyong mga kasukasuan ay maaaring maramdaman na matigas at mahirang gumalaw. Ang stiffness na ito ay karaniwang umaayos habang nagiging aktibo ka sa loob ng araw. Gayunpaman, ang sobrang pagpilit ay maaaring magdulot ng paglala ng sakit sa huli. Maaari mo ring maranasan ang sakit sa gabi, na maaaring makagambala sa iyong pagtulog. Ang pagtulog sa apektadong gilid ay maaaring magdagdag ng presyon sa mga pamamagang kasukasuan, na nagiging sanhi ng hirap sa paghanap ng komportableng posisyon.

Sa ilang kaso, maaari kang maranasan ang pamamaga sa paligid ng iyong mga bukong-bukong. Ito ay maaaring magdulot ng mga intermittent na sintomas na pumapasok at lumalabas. Maaari mong hindi agad mapansin ito dahil hindi konstante ang sakit. Maaari itong manatili sa loob ng mahabang panahon bago mo ikonekta ito sa iyong pangkalahatang kalusugan. Ang iyong doktor ay maghahanap ng mga senyales na ito upang maunawaan kung paano nakakaapekto ang kondisyon sa iyo.

Ang pamumuhay na may inflammatory arthritis ay nangangailangan ng pamamahala sa mga itaas at ibaba. Maaari kang magkaroon ng mga magandang araw kung saan normal ka, sinundan ng mga araw kung saan ang mga simpleng gawain ay nagiging hamon. Ang pag-unawa sa mga pattern na ito ay tumutulong sa iyong care team na suportahan ka nang mas mahusay. Maaari nilang i-adjust ang iyong gamutan upang matulungan ang pagbawas ng sakit at pagpapabuti ng iyong araw-araw na pagganap. Hindi ka nag-iisa sa karanasang ito. Maraming tao na may rheumatoid arthritis ang nakakaranas ng katulad na mga hamon. Sa tamang pag-aalaga, maaari kang maghanap ng mga paraan upang pamahalaan ang mga sintomas at manatiling aktibo.

Ano ang nangyayari talaga

Ang iyong immune system ay isang network ng depensa na karaniwang lumalaban sa mga mikrobyo. Sa rheumatoid arthritis, ito ay maling sumasalakay sa iyong mga kasu-kasuan. Tinatrato nito ang makinis na lining ng iyong kasu-kasuan bilang isang mananakaw. Dahil dito, namamaga at namamaga ang lining. Ang pamamaga ay nagdudulot ng presyon at sakit. Sa paglipas ng panahon, ang pamamaga ay nakakasira sa cartilage at sa buto sa loob ng kasu-kasuan.

Ang cartilage ay ang makinis na patong sa mga dulo ng iyong mga buto. Ito ay gumagana tulad ng shock absorber sa isang sasakyan. Pinapayagan nitong dumulas ang iyong mga buto sa isa’t isa nang walang friction. Ang pamamaga ay kumakain sa protektadong patong na ito. Kung walang ito, ang mga buto ay direktang magkikiskisan. Ito ay nagdudulot ng stiffness, pakiramdam ng pagkikiskisan, at malaking sakit. Ang joint capsule, na ang manggas sa paligid ng kasu-kasuan, ay nagkakapal din. Ito ay nagpapalala pa sa paggalaw at nagpahirap sa mga pang-araw-araw na gawain.

Ang prosesong ito ay naiiba sa wear-and-tear arthritis. Sa wear-and-tear arthritis, ang pinsala ay galing sa edad at paggamit. Sa rheumatoid arthritis, ang pinsala ay galing sa aktibong panloob na pag-atake. Ito ang dahilan kung bakit binibigyang-pansin ng iyong doktor ang iyong kabuuang kalusugan. Ang mga pasyente na may rheumatoid arthritis ay may mas mataas na panganib ng mga komplikasyon pagkatapos ng operasyon kumpara sa mga may simpleng wear-and-tear arthritis. Ang pamamaga ay maaaring makaapekto sa paggaling at magdagdag ng tsansang kailangan ng revision surgery.

Tinitingnan ng iyong doktor ang buong larawan. Tinutukoy nila kung paano naaapektuhan ng sakit ang iyong mga buto at malambot na tisyu. Tinitingnan din nila ang iyong ibang kondisyon sa kalusugan. Halimbawa, ang rheumatoid arthritis ay maaaring mahinain ang mga buto, na nagdudulot ng osteoporosis. Ito ay nagpapababa ng katatagan ng istruktura ng buto. Ang iyong plano ng paggamot ay tumutugon sa pinsala sa kasu-kasuan at sa likod na immune response. Ang layunin ay ihinto ang pag-atake, bawasan ang sakit, at ibalik ang function nang ligtas.

Ano ang maaari naming gawin dito

Magsimula sa sariling pag-aalaga at paggalaw. Ang banayad na ehersisyo at pisyoterapiya ay tumutulong upang panatilihing flexible at malakas ang iyong mga kasukasuan. Layunin ng rutinang ito na bawasan ang katigasan at mapanatili ang iyong pang-araw-araw na pagganap. Bigyan ng makatarungang pagsubok ang mga pamamalaang ito sa loob ng ilang linggo. Mas mahalaga ang konsistensya kaysa sa intensidad. Pakikinig sa iyong katawan at i-adjust ang mga gawain upang maiwasan ang sakit.

Ang medikal na pamamahala ay nakatuon sa pagkontrol ng pamamaga at pagprotekta sa iyong mga buto. Maaaring magreseta ang iyong doktor ng gamot pang-alis ng sakit at anti-inflammatories upang bawasan ang hindi komportableng pakiramdam. Para sa mga pasyenteng may rheumatoid arthritis at osteoporosis, tumutulong ang denosumab upang mapanatili ang kalusugan ng buto at maiwasan ang pinsala sa kasukasuan. Kung ikaw ay kumukuha ng biologic disease-modifying antirheumatic drugs, ang pagpapatuloy nito sa paligid ng oras ng elective hand surgery ay hindi malaki ang pagtaas ng panganib ng failure sa paggaling ng sugat o surgical site infections. Bibigyan ka ng doktor ng impormasyon mula sa internet tungkol sa mga opsyon sa paggamot upang matulungan kang gumawa ng mga desisyong may kaalaman habang nagkukonsulta.

Kung nananatiling matindi ang mga sintomas kahit na ang mga hakbang na ito, humingi ng input mula sa espesyalista. Maaaring irefer ka ng doktor para sa karagdagang pagsusuri. Sa ilang kaso, maaaring isaalang-alang ang isang proseso upang ibalik ang pagganap. Halimbawa, ang total hip arthroplasty ay maaaring bawasan ang sakit at mapabuti ang mga resulta na katulad ng nakikita sa mga pasyenteng may osteoarthritis. Ang total knee arthroplasty ay nagdudulot din ng malaking pagpapabuti sa mga resulta na ulit-ulit ng doktor at ng pasyente. Gayunpaman, maging alerto na ang rheumatoid arthritis ay maaaring makaapekto sa mga resulta ng operasyon nang iba-iba depende sa kasukasuan. Ang total elbow arthroplasty ay may mas mataas na long-term revision rates sa rheumatoid arthritis kumpara sa mga kaso na hindi rheumatoid. Ang total shoulder arthroplasty ay may kaugnayan sa mas mataas na rates ng systemic at joint-related complications sa inflammatory arthritis. Ang total ankle arthroplasty ay maaaring magresulta sa mas mahinang patient-reported outcomes kumpara sa ibang uri ng arthritis, bagaman inaasahan pa rin ang functional improvement mula sa baseline. Timbangin ng iyong doktor ang mga panganib at benepisyo na ito upang matukoy ang pinakamainam na landas para sa iyong partikular na kondisyon.

Ano ang inaasahan

Ang iyong prognosis ay nakadepende nang malaki sa kung aling kasu-kasuan ang apektado at sa uri ng arthritis na iyong nararanasan. Sa pangkalahatan, ang inflammatory arthritis ay lumilikha ng mas kumplikadong larawan medikal kumpara sa wear-and-tear arthritis. Kung ikaw ay gagawa ng joint replacement surgery, ang iyong doktor ay magmamaneho ng iyong pangkalahatang kalusugan nang maingat. Ito ay dahil ang inflammatory arthritis ay may kaugnayan sa mas mataas na panganib ng systemic complications sa unang 90 araw pagkatapos ng shoulder surgery. Maaari ka ring harapin ang mas mataas na panganib ng mga isyu na may kinalaman sa kasu-kasuan kumpara sa mga pasyente na may primary wear-and-tear arthritis.

Sa kabila ng mga karagdagang panganit na ito, maraming pasyente ang nakakakita ng malalaking benepisyo. Kung ikaw ay aabot sa total knee replacement, maaari kang mag-expect ng makabuluhang pagpapabuti sa parehong antas ng sakit at araw-araw na pagganap. Malamang na ipapahayag ng iyong doktor ang katulad na positibong pagbabago sa kanilang mga pagsusuri. Ang total hip replacement ay nag-aalok din ng matibay na resulta. Karamihan sa mga pasyente na may inflammatory arthritis ay nakakaranas ng bawas na sakit at mas mahusay na galaw na tumutugma sa mga resulta na nakikita sa mga pasyente na may wear-and-tear arthritis. Kahit pagkatapos ng ankle replacement, dapat mong makita ang functional improvement mula sa iyong starting point, bagama't maaaring medyo mas mababa ang iyong mga final scores kumpara sa iba pang mga uri ng arthritis.

Ang long-term results ay nag-iiba depende sa kasu-kasuan. Ang mga elbow replacement ay karaniwang tumatagal nang maayos sa simula, ngunit maaari kang kailangang magkaroon ng revision surgery nang mas madalas kaysa sa isang taong walang inflammatory arthritis. Ang mga wrist replacement ay maaaring magbigay ng magandang alignment at kaginhawaan sa loob ng maraming taon, bagama't ang ilang mga implant ay maaaring magka-fail sa huli sa loob ng mahabang panahon. Ang hand surgery ay karaniwang ligtas kahit patuloy kang gagamitin ang iyong mga biologic medications, na walang makabuluhang pagtaas ng mga problema sa paggaling ng sugat.

Kung hindi mo pupursiguhin ang surgical intervention, ang kondisyon ay karaniwang nananatili at umuunlad. Ang pinsala sa kasu-kasuan ay madalas na patuloy, at ang kalusugan ng buto ay maaaring bumaba, lalo na kung mayroon ka ring osteoporosis. Kung walang gamutan, malamang na mararanasan mo ang patuloy na sakit at bawas na pagganap. Ang surgical management ay nag-aalok ng malinaw na landas upang ibalik ang galaw at bawasan ang sakit, ngunit ito ay nangangailangan ng maingat na pagpaplano upang harapin ang natatanging mga panganib na dala ng iyong kondisyon. Ang iyong doktor ay magtatakda ng iyong pag-aalaga upang tugunan ang mga partikular na hamong ito at tulungan kang makamit ang pinakamahusay na posibleng kalidad ng buhay.

Kailan kumonsulta sa doktor

Kumonsulta sa iyong doktor kung mayroon kang patuloy na sakit na hindi gumagaling kahit magpahinga. Humingi ng pagsusuri ng espesyalista kung napapansin mo ang kahinaan o kawalan ng katatagan sa iyong mga kasukasuan. Humingi ng tulong kung ang iyong mga kasukasuan ay nakakabit o bumabagsak habang ginagamit. Kontakin ang iyong doktor kung ang mga sintomas ay nakakaapekto sa iyong tulog o trabaho. Biglaang paglala ng iyong kondisyon ay dahilan din upang humingi ng pag-aalaga. Magkaroon ng kamalayan na ang kronikong pamamaga sa mga lugar tulad ng bukong-bukong ay maaaring magdulot ng intermitenteng mga sintomas na hindi nakikilala sa loob ng ilang buwan o taon. Ang maagang pagsusuri ay tumutulong upang ma-manage ang mga pagbabagong ito nang epektibo.

Mas malalim na pagsusuri

Ang seksyong ito ay nag-aalok ng mas detalyadong paliwanag na angkop sa antas ng mag-aaral. Hindi ito kinakailangan sa pamamahala ng kondisyon, ngunit kung nais mong malaman ang bakit ito nakakasama sa mga kasu-kasuan at kung paano pinatutugunan ng mga modernong gamot ang kondisyong ito, magpatuloy sa pagbabasa.

Isang autoimmune na pag-atake sa lining ng kasu-kasuan

Hindi tulad ng osteoarthritis (isang mekanikal na pagkasira ng cartilage), ang rheumatoid at iba pang inflammatory arthritis ay isang autoimmune disease: ang immune system ay maling umiatake sa sariling synovium ng katawan, na manipis na lining ng kasu-kasuan. Ang synovium ay nagiging inflamed at nagkakapal na nagiging agresibo at invasive na tissue na tinatawag na pannus na dahan-dahang sumasakop at nagsisimulang kumain ng cartilage at buto.

Ang mga cytokine na messenger — at bakit gumagana ang "biologics"

Ang inflamed na synovium ay nagpapadala ng mga chemical messenger (cytokines), lalo na ang TNF at IL-6, na nagpapalakas ng pamamaga, sakit, at pamamaga. Ito ang susi sa modernong paggamot: ang mga biologic na gamot ay dinisenyo upang harangan ang mga exact na messenger na ito (anti-TNF, anti-IL-6) o ang mga immune cell na gumagawa nito, mga precision tool na pumapatay ng mga specific na signal na nagpapatakbo ng sakit.

RANKL at mga erosyon ng buto

Ang pamamaga ay nagpapataas din ng RANKL, ang eksaktong switch na nag-activate ng mga osteoclast na nagdudissolve ng buto (tingnan kung paano gumagaling at nagre-remodel ang buto). Pinapagana ng RANKL ang mga osteoclast na kumakain ng buto sa mga gilid ng kasu-kasuan, na nagdudulot ng mga katangiang erosyon na nakikita sa X-ray. Dahil ang pagkawala ng butong ito ay halos hindi na maibabalik, ang pagkontrol sa pamamaga nang maaga, bago pa man bumuo ang mga erosyon, ang pinakamahalagang layunin.

Isang sakit sa buong katawan

Dahil ang problema ay isang aktibadong immune system sa buong katawan, ang inflammatory arthritis ay higit pa sa isang kondisyon sa kasu-kasuan: maaari itong magdulot ng pagkapagod at makaapekto sa mga mata, baga, mga ugat ng dugo, at puso. Kaya ito pinamamahalaan bilang isang kondisyon sa buong katawan, hindi lamang bilang isang problema sa kasu-kasuan.

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