Vol.21 No.4

Review Article

Recent trends in orthopedic surgery performed in Japan for rheumatoid arthritis

Authors

Shigeki Momohara1 , Sakae Tanaka2 , Hiroshi Nakamura3 , Junya Mibe4 , Takuji Iwamoto1 , Katsunori Ikari1 , Jinju Nishino5 , Yuho Kadono2 , Tetsuro Yasui2 , Kenji Takahashi3 , Kenji Takenouchi3 , Kenzo Hashizume8, Ryuichi Nakahara8, Ayako Kubota7, Takashi Nakamura7, Keiichiro Nishida6, Toru Suguro7

  • Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women’s Medical University, 10-22 Kawada, Shinjuku, Tokyo 162-0054, Japan
  • Department of Orthopaedic Surgery, Faculty of Medicine, The University of Tokyo, Tokyo, Japan
  • Department Rheumatology, Nippon Medical School, Tokyo, Japan
  • Department of Orthopaedic Surgery, Tokyo Metropolitan Ohtsuka Hospital, Tokyo, Japan
  • Nishino Clinic Orthopedics and Rheumatology, Tokyo, Japan
  • Department of Human Morphology, Science of Functional Recovery and Reconstruction, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
  • Department of Orthopaedic Surgery, Toho University School of Medicine, Tokyo, Japan
  • Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan
Received:

12 November 2010

Accepted:

31 January 2011

Published online:

24 February 2011

Full Text

PDF　(member's only)

Abstract

The aim of this report was to review the use of orthopedic surgeries performed to manage rheumatoid arthritis (RA). Our review of studies published in English indicates that there has been a decrease in RA-associated surgeries in Western countries. Improvements in medical treatment may partly explain the reduction in numbers of orthopedic joint surgeries, which also suggests a worldwide trend toward improved long-term outcomes. However, the results of our multicenter study in Japan indicate that the number of RA-associated operations has not decreased, and that the numbers of operations performed annually have been relatively stable from 1998 to 2008. Although there definitely has been a decline in the numbers of synovectomy surgeries, the numbers of operations on the upper limbs and foot arthroplasties have increased. With the trend toward milder disease because of improved medical treatment, we speculate that RA patients may want and need better function for the activities of daily living. The combination of medical treatment and surgical intervention is thought to improve outcomes in RA patients who will develop joint destruction. Additional studies, including analyses of RA databases containing long-term data on a variety of surgical interventions, are needed.

Key words

Biologics - Orthopedic joint surgery - Paradigm shift - Rheumatoid arthritis