Surgical treatment of rheumatoid arthritis of the elbow.

Abstract

Rheumatoid arthritis (RA) is a chronic inflammatory condition that significantly impacts multiple joints, including the elbow, crucial for daily activities. Despite advancements in medical treatments like disease-modifying antirheumatic drugs that delay disease progression, surgical interventions are often necessary to improve the quality of life in RA patients. This review provides a comprehensive evaluation of the elbow, focusing on history taking, physical examination, and radiographic assessments, particularly magnetic resonance imaging findings. We detail the selection and counseling of patients, as well as various surgical options tailored to specific symptoms of RA elbow, including synovectomy for persistent pain due to synovitis, capsulotomy and osteophytectomy for limited range of motion, cubital tunnel release for ulnar neuropathy, and joint replacement or interposition arthroplasty for advanced joint destruction. Additionally, we emphasize the differentiation between RA flare and septic elbow, highlighting the importance of timely and accurate diagnosis. The review underscores the necessity of a multidisciplinary approach, integrating surgical and medical strategies to manage RA elbow effectively.