Recent trends in orthopedic surgery performed in Japan for rheumatoid arthritis

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.

Rheumatoid arthritis of the hand: a five-year longitudinal analysis of clinical and radiographic findings

“…It is also necessary to expect the progression of deformities and evaluate rehabilitation and surgical treatment in patients who have already developed finger deformities. Momohara et al [15] reported that the total number of operations for RA decreased while joint reconstruction surgery of the upper extremities did not. This indicates the necessity for conservation of joint function and the level of patient requirements have been expanding.…”

Early medication use in new-onset rheumatoid arthritis may delay joint replacement: results of a large population-based study

“…Similar conclusions were reached in a Finnish study [ 21 ]. Conversely, a multicenter study in Japan did not observe a decrease in the rates of RA-associated orthopedic surgery from 1998–2008, despite a steady increase in the proportion of patients using biologics from 2004 (1.8 %) to 2007 (10.0 %) [ 22 ]. One possible explanation for that finding is that in more recent years, patients who seek greater levels of activity may be undergoing joint surgery earlier than patients in the past.…”

Reduction in Upper Limb Joint Surgery Among Rheumatoid Arthritis Patients: An Interrupted Time‐Series Analysis Using Danish Health Care Registers

“…However, in the study by Young et al, although the proportion of patients with RA among shoulder replacement recipients decreased, the absolute numbers of RA patients undergoing shoulder surgery looked as if they increased . In a study from Japan, Momohara et al reported an increase in finger arthroplasty surgery, whereas the number of elbow and wrist joint replacements remained constant from 1998 to 2008.…”

“…There are studies reporting decreases in upper limb joint replacements among patients with RA during recent decades, but in most studies, these changes started in the mid‐1990s before bDMARDs were available . Other studies suggest that no changes have occurred for rates of joint replacements among RA patients during recent decades .…”