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Rheumatology Advance Access originally published online on March 7, 2006
Rheumatology 2006 45(6):779; doi:10.1093/rheumatology/kel069
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© The Author 2006. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

LETTER TO THE EDITOR

Surgery in rheumatoid arthritis: reply

G. Pomponio, L. Ghattas and F. Mascella

Università Degli Studi di Ancona, Clinica Medica, Ancona, Italy

Correspondence to: G. Pomponio, Istituto di Clinica Medica, Ematologia ed Immunologia Clinica, Università di Ancona, Via Conca, 1 60020, Italy. E-mail: pomponio{at}univpm.it

SIR, The correspondence by Dr Trieb raises the important issue of whether and to what extent medical therapy has reduced the need for surgery in rheumatoid arthritis (RA). Recently introduced drugs have effectively slowed down disease progression in RA patients, thus delaying the onset of disabilities and improving the overall quality of life [1, 2]. These improvements in medical treatment may explain, at least in part, the reduced need for surgery that has been reported in large cohorts of RA patients [3, 4]. It should be noted, however, that the indications for surgical treatment in the setting of RA remain uncertain and somewhat controversial [5]. It is hoped that further clinical investigation may soon provide a better assessment of the role of surgery in the clinical management of RA patients.

References

  1. Navarro-Sarabia F, Ariza-Ariza R, Hernandez-Cruz B, Villanueva I. Adalimumab for treating rheumatoid arthritis. Cochrane Database Syst Rev 2005;3:CD005113.
  2. Kremer JM. Rational use of new and existing disease-modifying agents in rheumatoid arthritis Ann Intern Med 2001; 134:695–706.[Abstract/Free Full Text]
  3. da Silva E, Doran MF, Crowson CS, O’Fallon WM, Matteson EL. Declining use of orthopedic surgery in patients with rheumatoid arthritis? Results of a long-term, population-based assessment. Arthritis Rheum 2003;49:216–20.[CrossRef][Web of Science][Medline]
  4. Weiss RJ, Stark A, Wick MC, Ehlin A, Palmblad K, Wretenberg P. Orthopaedic surgery of the lower limbs in 49,802 rheumatoid arthritis patients: results from the Swedish National Inpatient Registry during 1987–2001. Ann Rheum Dis 2006;65:335–41.[Abstract/Free Full Text]
  5. Alderman AK, Ubel PA, Kim HM, Fox DA, Chung KC. Surgical management of the rheumatoid hand: consensus and controversy among rheumatologists and hand surgeons. J Rheumatol 2003;30:1464–72.[Abstract/Free Full Text]
Accepted 7 February 2006


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This Article
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Right arrow Articles by Pomponio, G.
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