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भड़काऊ और रुमेटोइड आर्थराइटिस

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Rheumatoid, psoriatic and gouty arthritis affecting the hand, wrist and upper limb — what they are, how they are managed, and when surgery helps.

Updated Sep 2026
सूजनयुक्त जोड़ों वाला हाथ।
भड़काऊ गठिया संयुक्त अस्तर पर हमला करता है, जिसके कारण सूजन, कठोरता और, अनुपचारित, संयुक्त क्षति होती है। Kieran Hirpara 4.0

यह पृष्ठ मशीन द्वारा अनूदित है और अभी तक किसी चिकित्सक द्वारा जाँचा नहीं गया है। अंग्रेज़ी संस्करण ही आधिकारिक है।

आप क्या महसूस कर रहे हैं

भड़काऊ गठिया, जिसमें रूमेटोइड गठिया भी शामिल है, एक ऐसी स्थिति है जहां आपकी प्रतिरक्षा प्रणाली आपके जोड़ों के अस्तर पर हमला करती है। इससे कई जोड़ों में एक साथ सूजन, दर्द और कड़ाई होती है। एक ही रोग प्रक्रिया आपके कंधे, कोहनी, कलाई, कूल्हे, घुटने या टखने को प्रभावित कर सकती है।

दर्द आमतौर पर सुबह में अधिक होता है और दिन के दौरान जब आप घूमते हैं तो यह कम हो सकता है। विश्राम एक फ्लेयर को शांत कर सकता है, लेकिन थोड़ी देर के लिए अभी भी बैठने के बाद कठोरता अक्सर वापस आती है। कई लोगों को पता चलता है कि उनके लक्षण आते-जाते रहते हैं, फ्लेयर के बीच शांत अवधि के साथ।

जैसे-जैसे यह स्थिति आपके जोड़ों को प्रभावित करती है, रोजमर्रा के काम कठिन हो सकते हैं। एक दरवाज़े के हैंडल को मोड़ना, एक केतली उठाना, खरीदारी करना या कुर्सी से उठना पहले की तुलना में अधिक प्रयास कर सकता है। यदि आपके कूल्हे, घुटने या टखने में चोट है तो लंबी दूरी तक चलना असहज हो सकता है। आपकी कलाई या कोहनी प्रभावित होने पर छोटी वस्तुओं को लिखना, टाइप करना या पकड़ना मुश्किल हो सकता है।

आप जोड़ों से परे स्थिति के प्रभावों को भी महसूस कर सकते हैं। लगातार दर्द और जकड़न के साथ रहना आपके मनोदशा और ऊर्जा के स्तर को प्रभावित कर सकता है, और यह बदले में बदल सकता है कि आप दिन-प्रतिदिन कितना दर्द महसूस करते हैं।

यदि आपके जोड़ समय के साथ खराब हो गए हैं, तो संयुक्त प्रतिस्थापन सर्जरी दर्द को कम कर सकती है और जोड़ों के कामकाज में सुधार कर सकती है। यह कंधे, कोहनी, कलाई, कूल्हे, घुटने और टखने पर लागू होता है। आंदोलन और आराम की वसूली अक्सर तत्काल के बजाय धीरे-धीरे होती है, और यह उस जगह से बनती है जहां आप ऑपरेशन से पहले थे।

चूंकि भड़काऊ गठिया आपके पूरे शरीर के साथ-साथ आपके जोड़ों को भी प्रभावित करता है, इसलिए यह अकेले पहनने और आंसू गठिया की तुलना में सर्जरी के बाद जटिलताओं की थोड़ी अधिक संभावना ला सकता है। आपका डॉक्टर आपके साथ इस बारे में चर्चा करेगा, साथ ही यह भी बताएगा कि आपकी अन्य दवाएं और स्वास्थ्य स्थितियां योजना में कैसे फिट होती हैं।

वास्तव में क्या हो रहा है

एक स्वस्थ जोड़ में, हड्डियों के छोरों को चिकनी कार्टिलेज से ढक दिया जाता है, एक फिसलन वाला कुशन जो सतहों को एक दूसरे पर फिसलने देता है। जोड़ के चारों ओर एक पतली अस्तर तरल पदार्थ बनाता है जो सब कुछ स्वतंत्र रूप से चलता रहता है, दरवाजे के झंझरी में तेल की तरह।

भड़काऊ गठिया के साथ, आपकी प्रतिरक्षा प्रणाली इस अस्तर को कुछ हानिकारक के लिए गलत समझती है और उस पर हमला करती है। अस्तर सूज जाता है और बहुत अधिक तरल पदार्थ पैदा करता है, इसलिए जोड़ फुला जाता है और कठोर महसूस होता है। समय के साथ, चल रही सूजन उपास्थि तकिया को खा जाती है और स्नायुओं को भी कमजोर कर सकती है, मांसपेशियों को हड्डी से जोड़ने वाले कॉर्ड। यही कारण है कि सुबह आपके जोड़ों में जकड़न महसूस होती है, फ्लेयर आते-जाते रहते हैं, और जब जोड़ों की सतह खस्ता हो जाती है तो पकड़ना या चलना कठिन हो जाता है।

चूंकि यह बीमारी आपके पूरे शरीर को प्रभावित करती है, न कि एक थके हुए जोड़ को, इसलिए यह एक बार में कई जोड़ों को प्रभावित कर सकती है और आपकी हड्डियों की ताकत और संक्रमणों के प्रति आपकी प्रतिक्रिया को भी प्रभावित कर सकती है। यही कारण है कि सूजन वाले जोड़ पर की जाने वाली सर्जरी में जटिलताओं की संभावना केवल पहनने और फाड़ने वाले गठिया के लिए सर्जरी की तुलना में थोड़ी अधिक होती है, और यही कारण है कि ऑपरेशन की सिफारिश करने से पहले आपका डॉक्टर आपकी दवाओं और सामान्य स्वास्थ्य को बारीकी से देखता है।

जब जोड़ बुरी तरह से क्षतिग्रस्त हो जाता है, तो संयुक्त प्रतिस्थापन सर्जरी मदद कर सकती है। पहनी हुई सतहों को कृत्रिम जोड़ से बदलने से दर्दनाक घर्षण दूर हो जाता है। रुमेटोइड गठिया वाले लोग जिनके पास कूल्हे, घुटने या कंधे की प्रतिस्थापन होती है, आमतौर पर बाद में कम दर्द और बेहतर कार्य की रिपोर्ट करते हैं, जैसे कि पहनने और आंसू गठिया वाले लोग करते हैं।

हम इसके बारे में क्या कर सकते हैं

बहुत कुछ है जो आप स्वयं कर सकते हैं। धीरे-धीरे और नियमित रूप से व्यायाम करने से आपके जोड़ों की गति बनी रहती है और आपके हृदय तथा सामान्य स्वास्थ्य की रक्षा होती है। पर्यवेक्षित उच्च तीव्रता वाले अंतराल प्रशिक्षण और शक्ति अभ्यास अच्छी तरह से नियंत्रित रूमेटोइड गठिया वाले लोगों द्वारा संभव और अच्छी तरह से सहन किए जाते हैं, इसलिए उन्हें हृदय और शारीरिक स्वास्थ्य में सुधार के लिए अनुशंसित किया जा सकता है। शारीरिक और व्यावसायिक चिकित्सा भी आपको रोजमर्रा के कार्यों को संभालने में मदद कर सकती है। ये दृष्टिकोण आपके लिए काम कर रहे हैं या नहीं यह निर्णय करने से पहले कई हफ्तों तक निष्पक्ष रूप से जाने के लायक हैं।

आरंभिक रूमेटोइड गठिया में दवाएं भारी उठाने का काम करती हैं। विरोधी भड़काऊ दवाएं और कॉर्टिकोस्टेरॉयड दर्द और सूजन को कम करते हैं। मेथोट्रेक्सेट और जैविक एजेंट प्रतिरक्षा प्रणाली को शांत करते हैं जो आपके जोड़ों पर हमला कर रहा है। जैविक एजेंट प्रयोगशाला-निर्मित प्रोटीन होते हैं जो आम तौर पर ट्यूमर नेक्रोसिस फैक्टर नामक सूजन संदेशवाहक को लक्षित करते हैं, और उन्होंने उपचार में उत्कृष्ट परिणाम दिखाए हैं। क्योंकि वे आपकी प्रतिरक्षा प्रणाली को कमजोर करते हैं, वे संक्रमण के बढ़ते जोखिम को ले जाते हैं, इसलिए इस व्यापार को आपके डॉक्टर के साथ तौलने की आवश्यकता है। आधुनिक चिकित्सा प्रबंधन ने एक वास्तविक अंतर किया हैः रूमेटोइड गठिया के लिए किए गए संयुक्त प्रतिस्थापन की संख्या 1995 और 2010 के बीच 48% कम हो गई, जो बेहतर चिकित्सा प्रबंधन की प्रभावशीलता के लिए जिम्मेदार है।

यदि इन उपचारों के बावजूद आपके लक्षण गंभीर रहते हैं, तो आपका डॉक्टर आपको विशेषज्ञ मूल्यांकन के लिए भेज सकता है। आपका डॉक्टर आपकी दवाइयों और सामान्य स्वास्थ्य पर बारीकी से नज़र रखेगा, क्योंकि कुछ दवाइयों को ऑपरेशन के आसपास रोकना पड़ता है। प्रतिरक्षा-प्रणाली-दमनकारी दवाओं को आमतौर पर सर्जरी से कम से कम 1 सप्ताह पहले और सर्जरी के बाद 1 सप्ताह के लिए रोक दिया जाता है, और कॉर्टिकोस्टेरॉइड पर लोगों को आमतौर पर ऑपरेशन के समय के आसपास हाइड्रोकोर्टिसोन की अतिरिक्त खुराक की आवश्यकता होती है। गंभीर रूप से क्षतिग्रस्त जोड़ों वाले कुछ लोगों के लिए, कभी-कभी एक प्रक्रिया पर विचार किया जा सकता है।

क्या उम्मीद करें

रूमेटोइड गठिया एक दीर्घकालिक स्थिति है, और अधिकांश लोगों के लिए यह आता है और चला जाता है। शांत अवधि फ्लेयर के बीच बैठती है, और सूजन और कठोरता अच्छे के लिए गायब होने के बजाय बढ़ते और घटते हैं। चूंकि यह आपके पूरे शरीर को प्रभावित करता है, इसलिए कई जोड़ एक साथ प्रभावित हो सकते हैं, हालांकि आपके हाथों और पैरों के छोटे जोड़ सबसे अधिक प्रभावित होते हैं।

उपचार के बिना, सूजन आपके जोड़ों पर काम करती रहती है। संयुक्त क्षति आमतौर पर पहले या दूसरे वर्ष के भीतर शुरू होती है और वहां से जारी रहती है। समय के साथ यह दर्द के रूप में प्रकट होता है जब आप जोड़ का उपयोग करते हैं, और जोड़ धीरे-धीरे आकार बदल सकते हैं। प्रारंभिक उपचार इस कारण से महत्वपूर्ण है: जल्दी शुरू की गई दवाएं सूजन को शांत कर सकती हैं इससे पहले कि यह संयुक्त सतहों को नीचे ले जाए।

अच्छी तरह से प्रबंधित उपचार के साथ, दृष्टिकोण अलग है। आधुनिक दवाएं सूजन को कम कर सकती हैं और आगे की क्षति को धीमा कर सकती हैं या रोक सकती हैं, और कई लोग वर्षों तक आराम से सक्रिय रहते हैं। कुछ लोग एक ऐसी अवस्था तक पहुँचते हैं जहां उनकी बीमारी शांत हो जाती है, जिसे डॉक्टर छूट कहते हैं। यदि एक जोड़ पहले से ही बुरी तरह से क्षतिग्रस्त है, तो संयुक्त प्रतिस्थापन सर्जरी अभी भी दर्द को कम कर सकती है और जोड़ों के कामकाज को बेहतर बना सकती है, जैसा कि यह पहनने और आंसू गठिया के लिए करता है।

यह कहना सही होगा कि सर्जरी के बाद होने वाले परिणाम जोड़ों के अनुसार अलग-अलग होते हैं। हिप प्रतिस्थापन के बाद, रुमेटोइड गठिया वाले लोग आम तौर पर कम दर्द और बेहतर कार्य की रिपोर्ट करते हैं, जो कि पहनने और आंसू गठिया वाले लोगों के समान है, हालांकि कुछ हद तक जटिलताओं या ट्रैक के नीचे आगे की सर्जरी की संभावना अधिक है। टखने के प्रतिस्थापन के बाद, रूमेटोइड गठिया वाले लोग अन्य प्रकार के गठिया वाले लोगों की तुलना में दिन-प्रतिदिन के स्कोर में कम सुधार की रिपोर्ट करते हैं, लेकिन वे अभी भी सुधार करते हैं जहां उन्होंने शुरू किया था। कलाई प्रतिस्थापन ने सर्जरी के बाद 10 वर्षों तक अच्छे परिणाम दिखाए हैं। आपका डॉक्टर आपको बताएगा कि आपके विशेष जोड़ के लिए इसका क्या अर्थ है।

जो भी संयुक्त है, यथार्थवादी तस्वीर रातोंरात ठीक होने के बजाय हफ्तों और महीनों में धीरे-धीरे प्रगति है, जो निरंतर चिकित्सा देखभाल पर निर्मित है, आपके जोड़ों को चलाने के लिए, और सर्जरी जहां यह वास्तव में आवश्यक है।

किसी से कब मिलना है

भड़काऊ गठिया एक ऐसी स्थिति है जिसे आपका जीपी और रुमेटोलॉजी टीम दिन-प्रतिदिन प्रबंधित करती है, इसलिए आपकी अधिकांश नियुक्तियां उनके साथ होंगी। यदि कोई जोड़ दवाओं के बावजूद दर्दनाक, सूजन या कठोर रहता है, या यदि कोई जोड़ आकार बदल गया है या रोजमर्रा के कार्यों को बहुत कठिन बना रहा है, तो एक विशेषज्ञ की समीक्षा के लिए पूछें। आपका GP यह भी जांच कर सकता है कि आपका वर्तमान उपचार कितना अच्छा काम कर रहा है।

यदि आप किसी एक जोड़ में गर्मी, लाली या सूजन महसूस करते हैं जो आपके सामान्य फ्लेयर की तुलना में बहुत अधिक दर्दनाक है, खासकर यदि आपको बुखार या अस्वस्थ महसूस होता है, तो तुरंत अपने डॉक्टर से मिलें। एक सूजनयुक्त जोड़ कभी-कभी संक्रमित हो सकता है, और इसके लिए तुरंत मूल्यांकन की आवश्यकता होती है।

यदि आपको बुखार के साथ एक गर्म, गंभीर रूप से दर्दनाक जोड़ है और आप तत्काल जीपी देखभाल प्राप्त नहीं कर सकते हैं, या यदि आप आम तौर पर जोड़ के आसपास लाली फैलाने के साथ अस्वस्थ महसूस करते हैं तो आपातकालीन विभाग में जाएं।

Reviewed by Kieran Hirpara · 13 June 2026.

Want the clinical detail? Read the clinician version.

Talk to your treating clinician for advice specific to you.

For an appointment with the CQ Hand + Upper Limb team, ask your GP about a referral or visit www.cqupperlimb.com.

Evidence & references

This is the clinical evidence summary written for health professionals. It is technical, and it lists the research this page was built from. You do not need to read it to understand your treatment or to make a decision about it.

Overview

  • The volume of total joint arthroplasty procedures in patients with rheumatoid arthritis has trended markedly upward over the past decade, with a sharp increase after 2015 [1].
  • Inflammatory arthritis is associated with higher rates of medical and surgical complications compared to osteoarthritis in patients undergoing anatomic or reverse total shoulder arthroplasty [9].
  • Following total shoulder arthroplasty, patients with rheumatoid arthritis are at higher risk of systemic and joint-related complications compared to patients with primary osteoarthritis [5].
  • Despite comparable complication rates between rheumatoid arthritis and non-rheumatoid arthritis cohorts, rheumatoid arthritis patients have increased revision rates in total elbow arthroplasty [2].
  • Following primary total hip arthroplasty, patients with rheumatoid arthritis can expect reduced pain and improved functional outcomes similar to those with osteoarthritis [6].
  • Patients with rheumatoid arthritis undergoing primary total hip arthroplasty may be at an increased risk of complications and revision surgery [6].
  • In the largest single-institution study to date, patients with rheumatoid arthritis reported poorer patient-reported outcome scores compared with osteoarthritis and posttraumatic arthritis groups after total ankle arthroplasty [7].
  • Patients with rheumatoid arthritis experienced functional outcome improvement from the preoperative baseline following total ankle arthroplasty [7].
  • Denosumab demonstrates promising efficacy in maintaining bone health and preventing joint damage in rheumatoid arthritis patients with coexisting osteoporosis [3].
  • Cutaneous psoriasis and psoriatic arthritis are associated with higher rates of infections and all-cause revisions following total hip arthroplasty [13].

Background & Causes

  • Patients with rheumatoid arthritis undergoing elective hand surgery who continue perioperative biologic disease-modifying antirheumatic drugs do not experience significant increases in risks of wound healing failures or surgical site infections [15].
  • Discontinuation of antiviral prophylaxis correlates with a high prevalence of hepatitis B virus reactivation in rheumatoid arthritis patients with a hepatitis B virus carrier state [17].
  • Preclinical evidence supports an antioxidant, anti-inflammatory, antinociceptive, cartilage- and bone-protective effect of calcitonin in rheumatoid arthritis and osteoarthritis [16].
  • Tectochrysin may act as a novel rheumatoid arthritis therapeutic agent via macrophage JAK/STAT pathway inhibition [14].

Symptoms & Presentation

  • Patients with rheumatoid arthritis who have undergone shoulder arthroplasty experience reduced pain and improved function [10].
  • In patients with rheumatoid arthritis, negative affect moderates pain following shoulder arthroplasty [10].
  • Patients with rheumatoid arthritis report poorer patient-reported outcome scores compared with osteoarthritis and posttraumatic arthritis groups following total ankle arthroplasty [7].
  • Patients with rheumatoid arthritis experience functional outcome improvement from the preoperative baseline following total ankle arthroplasty [7].
  • Total knee arthroplasty in patients with rheumatoid arthritis yields significant improvement in physician- and patient-reported outcomes [12].
  • Patients with rheumatoid arthritis can expect reduced pain and improved functional outcomes similar to those with osteoarthritis following primary total hip arthroplasty [6].
  • Patient-reported functional outcomes at 6 months following total elbow arthroplasty were significantly lower in the fracture group compared to osteoarthritis and rheumatoid arthritis groups [11].
  • The Kudo type-5 prosthesis demonstrated satisfactory results in patients with rheumatoid arthritis over a minimum 10-year follow-up period [18].
  • Failures of the Kudo type-5 prosthesis occurred to some extent over a long-term follow-up period in patients with rheumatoid arthritis [18].
  • HandScan optical imaging can reliably identify ultrasound-defined remission in rheumatoid arthritis at the joint level with good sensitivity and high positive predictive value [21].
  • DAS-OST can determine ultrasound remission in rheumatoid arthritis at the patient level but with lower performance than HandScan [21].

Management

Non-Operative

  • Rheumatoid arthritis is a chronic, systemic, inflammatory disease that most often involves the small joints of the hands and feet, although any synovial joint can be affected [19].
  • Rheumatoid arthritis affects 1% to 2% of the world population, with a female-to-male ratio of 2.5:1 [19].
  • Adult rheumatoid arthritis is usually polyarticular, while systemic involvement in visceral organs or eyes is rare [19].
  • The test for rheumatoid factor in adults is positive in 70% to 80% of patients diagnosed with rheumatoid arthritis [19].
  • A patient is considered to have rheumatoid arthritis if at least four of the seven American Rheumatism Association criteria have been present for at least 6 weeks [19].
  • The clinical picture of rheumatoid arthritis is characterized by synovitis and joint destruction, with synovitis tending to wax and wane [19].
  • Joint destruction in rheumatoid arthritis starts within the first or second year of the disease and continues to progress [19].
  • Radiographic signs of rheumatoid arthritis destruction include joint space narrowing, periarticular erosions, and subchondral osteopenia [19].
  • Structural damage in rheumatoid arthritis manifests as pain with activity and deformity [19].
  • Treatment of the early stages of rheumatoid arthritis is primarily medical, although physical and occupational therapy can be helpful [19].
  • Pharmacologic agents used in rheumatoid arthritis include nonsteroidal antiinflammatory drugs, corticosteroids, methotrexate, and biologic agents [19].
  • Biologic agents are recombinant proteins that generally target an inflammatory cytokine, such as tumor necrosis factor [19].
  • Biologic agents have shown excellent results in rheumatoid arthritis treatment [19].
  • Biologic agents inhibit the immune system and cause an increased risk of infection in patients taking them [19].
  • Jämsen et al. found a 48% decrease in the number of primary arthroplasties performed for rheumatoid arthritis between 1995 and 2010, attributed to the effectiveness of improved medical management [19].
  • There is preclinical evidence for an antioxidant, anti-inflammatory, antinociceptive, cartilage- and bone-protective effect of calcitonin in rheumatoid arthritis and osteoarthritis [16].
  • Tectochrysin may be a novel rheumatoid arthritis therapeutic agent acting via macrophage JAK/STAT pathway inhibition, with promising clinical potential [14].
  • Supervised high-intensity interval training and strength exercise appear to be feasible and well tolerated by patients and could be recommended to improve cardiovascular and physical health in patients with well-controlled rheumatoid arthritis [20].

Perioperative Medical Management

  • Patients with rheumatoid arthritis on corticosteroids generally require preoperative “stress” dosages of hydrocortisone [19].
  • Agents that inhibit the immune system should be withheld at least 1 week before and 1 week after a surgical procedure in patients with rheumatoid arthritis [19].
  • Among patients with rheumatoid arthritis undergoing elective hand surgery, perioperative biologic disease-modifying antirheumatic drug continuation was not associated with significant increases in risks of wound healing failures or surgical site infections [15].

Operative

  • The volume of total joint arthroplasty procedures conducted in patients with rheumatoid arthritis has trended markedly upward over the past decade, with a sharp increase after 2015 [1].
  • 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 total hip arthroplasty [6].
  • Following total shoulder arthroplasty, patients with rheumatoid arthritis should be considered at higher risk of systemic and joint-related complications compared to patients with primary osteoarthritis [5].
  • Shoulder arthroplasty in patients with rheumatoid arthritis reduces pain and improves function [10].
  • In the largest single-institution study to date, patients with rheumatoid arthritis reported poorer patient-reported outcome scores compared with osteoarthritis and posttraumatic arthritis groups but experienced functional outcome improvement from the preoperative baseline following total ankle arthroplasty [7].
  • Despite comparable complication rates between rheumatoid arthritis and non-rheumatoid arthritis cohorts, further investigation into the underlying mechanisms of increased revision rates in rheumatoid arthritis patients is warranted following total elbow arthroplasty [2].
  • Patient-reported functional outcomes at 6 months were significantly lower in the fracture group compared to osteoarthritis and rheumatoid arthritis groups following total elbow arthroplasty [11].
  • Comparative outcomes of robot-assisted versus conventional total knee arthroplasty provide important evidence for selecting surgical methods in rheumatoid osteoarthritis [4].

Key Considerations

Perioperative Risk and Complications

  • Patients with rheumatoid arthritis may be at an increased risk of complications and revision surgery following primary total hip arthroplasty [6].
  • Despite comparable complication rates between rheumatoid arthritis and non-RA cohorts in total elbow arthroplasty, further investigation into the underlying mechanisms of increased revision rates in RA patients is warranted [2].

Functional Outcomes and Patient-Reported Measures

  • In the largest single-institution study to date, patients with rheumatoid arthritis reported poorer patient-reported outcome scores compared with osteoarthritis and posttraumatic arthritis groups following total ankle arthroplasty [7].

Long-Term Survivorship and Device Performance

  • The Kudo type-5 prosthesis demonstrated satisfactory results in patients with rheumatoid arthritis, although failures occurred to some extent over a long-term follow-up period [18].
  • Radiolunate arthrodesis in patients with rheumatoid arthritis maintained good clinical results and corrected alignment during long-term follow-up [22].

Surgical Technique Selection

Patient Education

  • Physicians should provide information regarding the treatment of rheumatoid arthritis to patients in counseling and education materials [8].

Pharmacologic Management

Key Evidence

  • [L4] The volume of total joint arthroplasty (TJA) procedures conducted in patients with rheumatoid arthritis has trended markedly upward over the past decade, with a sharp increase after 2015. [1] (10.5435/jaaosglobal-d-22-00209)
  • [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. [2] (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. [3] (10.1186/s12891-025-08688-8)
  • [L3] This provides important evidence for selecting surgical methods in rheumatoid osteoarthritis. [4] (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. [5] (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. [6] (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. [7] (10.2106/jbjs.24.00048)
  • [L4] Physicians should provide such information to patients with RA in the counseling and education materials. [8] (10.1371/journal.pone.0285869)
  • [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. [9] (10.1016/j.jse.2023.09.014)
  • [L3] Shoulder arthroplasty in patients with rheumatoid arthritis reduces pain and improves function. [10] (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. [11] (10.1016/j.jse.2026.01.019)
  • [L3] Total knee arthroplasty in patients who have RA yields significant improvement in physician- and patient-reported outcomes. [12] (10.1016/j.arth.2026.03.021)
  • [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)
  • [L5] Tectochrysin may be a novel RA therapeutic agent, likely acting via macrophage JAK/STAT pathway inhibition, with promising clinical potential. [14] (10.1186/s13018-025-06481-w)
  • [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. [15] (10.1016/j.jhsa.2026.03.003)
  • [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] Discontinuation of antiviral prophylaxis correlates with high prevalence of hepatitis B virus (HBV) reactivation in rheumatoid arthritis patients with HBV carrier state. [17] (10.1186/1471-2474-15-449)
  • [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. [18] (10.1016/j.jse.2024.10.025)
  • [L1] Supervised HIIT and strength exercise appear to be feasible and well tolerated by patients and could be recommended to improve cardiovascular and physical health in patients with well-controlled RA. [20] (10.1136/bjsports-2024-108369)
  • [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. [21] (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. [22] (10.1016/j.jhsa.2022.11.014)

References

[1] Trends in Total Joint Arthroplasty Among Patients With Rheumatoid Arthritis: The Effect of Recent Disease Modifying Antirheumatic Drug Utilization Guidelines. JAAOS: Global Research and Reviews. 2022. DOI: 10.5435/jaaosglobal-d-22-00209

[2] 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

[3] 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

[4] 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

[5] 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

[6] 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

[7] 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

[8] 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

[9] 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

[10] 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

[11] 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

[12] 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

[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] 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

[15] 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

[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] Discontinuation of antiviral prophylaxis correlates with high prevalence of hepatitis B virus (HBV) reactivation in rheumatoid arthritis patients with HBV carrier state: a real-world clinical practice. BMC Musculoskeletal Disorders. 2014. DOI: 10.1186/1471-2474-15-449

[18] 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

[19] Campbell S Operative Orthopaedics 4 Volume Set. SOFT-TISSUE PROCEDURES AND OSTEOTOMIES ABOUT THE KNEE > RHEUMATOID ARTHRITIS OF THE KNEE > ADULT-ONSET RHEUMATOID ARTHRITIS.

[20] High-intensity interval training improves cardiovascular and physical health in patients with rheumatoid arthritis: a multicentre randomised controlled trial. British Journal of Sports Medicine. 2024. DOI: 10.1136/bjsports-2024-108369

[21] Optical imaging (HandScan) can identify ultrasound remission in rheumatoid arthritis. BMC Musculoskeletal Disorders. 2024. DOI: 10.1186/s12891-024-07472-4

[22] 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

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Section 4 -- Sui Generis Database Rights.

Where the Licensed Rights include Sui Generis Database Rights that apply to Your use of the Licensed Material:

a. for the avoidance of doubt, Section 2(a)(1) grants You the right to extract, reuse, reproduce, and Share all or a substantial portion of the contents of the database for NonCommercial purposes only;

b. if You include all or a substantial portion of the database contents in a database in which You have Sui Generis Database Rights, then the database in which You have Sui Generis Database Rights (but not its individual contents) is Adapted Material; and

c. You must comply with the conditions in Section 3(a) if You Share all or a substantial portion of the contents of the database.

For the avoidance of doubt, this Section 4 supplements and does not replace Your obligations under this Public License where the Licensed Rights include other Copyright and Similar Rights.

Section 5 -- Disclaimer of Warranties and Limitation of Liability.

a. UNLESS OTHERWISE SEPARATELY UNDERTAKEN BY THE LICENSOR, TO THE EXTENT POSSIBLE, THE LICENSOR OFFERS THE LICENSED MATERIAL AS-IS AND AS-AVAILABLE, AND MAKES NO REPRESENTATIONS OR WARRANTIES OF ANY KIND CONCERNING THE LICENSED MATERIAL, WHETHER EXPRESS, IMPLIED, STATUTORY, OR OTHER. THIS INCLUDES, WITHOUT LIMITATION, WARRANTIES OF TITLE, MERCHANTABILITY, FITNESS FOR A PARTICULAR PURPOSE, NON-INFRINGEMENT, ABSENCE OF LATENT OR OTHER DEFECTS, ACCURACY, OR THE PRESENCE OR ABSENCE OF ERRORS, WHETHER OR NOT KNOWN OR DISCOVERABLE. WHERE DISCLAIMERS OF WARRANTIES ARE NOT ALLOWED IN FULL OR IN PART, THIS DISCLAIMER MAY NOT APPLY TO YOU.

b. TO THE EXTENT POSSIBLE, IN NO EVENT WILL THE LICENSOR BE LIABLE TO YOU ON ANY LEGAL THEORY (INCLUDING, WITHOUT LIMITATION, NEGLIGENCE) OR OTHERWISE FOR ANY DIRECT, SPECIAL, INDIRECT, INCIDENTAL, CONSEQUENTIAL, PUNITIVE, EXEMPLARY, OR OTHER LOSSES, COSTS, EXPENSES, OR DAMAGES ARISING OUT OF THIS PUBLIC LICENSE OR USE OF THE LICENSED MATERIAL, EVEN IF THE LICENSOR HAS BEEN ADVISED OF THE POSSIBILITY OF SUCH LOSSES, COSTS, EXPENSES, OR DAMAGES. WHERE A LIMITATION OF LIABILITY IS NOT ALLOWED IN FULL OR IN PART, THIS LIMITATION MAY NOT APPLY TO YOU.

c. The disclaimer of warranties and limitation of liability provided above shall be interpreted in a manner that, to the extent possible, most closely approximates an absolute disclaimer and waiver of all liability.

Section 6 -- Term and Termination.

a. This Public License applies for the term of the Copyright and Similar Rights licensed here. However, if You fail to comply with this Public License, then Your rights under this Public License terminate automatically.

b. Where Your right to use the Licensed Material has terminated under Section 6(a), it reinstates:

1. automatically as of the date the violation is cured, provided it is cured within 30 days of Your discovery of the violation; or

2. upon express reinstatement by the Licensor.

For the avoidance of doubt, this Section 6(b) does not affect any right the Licensor may have to seek remedies for Your violations of this Public License.

c. For the avoidance of doubt, the Licensor may also offer the Licensed Material under separate terms or conditions or stop distributing the Licensed Material at any time; however, doing so will not terminate this Public License.

d. Sections 1, 5, 6, 7, and 8 survive termination of this Public License.

Section 7 -- Other Terms and Conditions.

a. The Licensor shall not be bound by any additional or different terms or conditions communicated by You unless expressly agreed.

b. Any arrangements, understandings, or agreements regarding the Licensed Material not stated herein are separate from and independent of the terms and conditions of this Public License.

Section 8 -- Interpretation.

a. For the avoidance of doubt, this Public License does not, and shall not be interpreted to, reduce, limit, restrict, or impose conditions on any use of the Licensed Material that could lawfully be made without permission under this Public License.

b. To the extent possible, if any provision of this Public License is deemed unenforceable, it shall be automatically reformed to the minimum extent necessary to make it enforceable. If the provision cannot be reformed, it shall be severed from this Public License without affecting the enforceability of the remaining terms and conditions.

c. No term or condition of this Public License will be waived and no failure to comply consented to unless expressly agreed to by the Licensor.

d. Nothing in this Public License constitutes or may be interpreted as a limitation upon, or waiver of, any privileges and immunities that apply to the Licensor or You, including from the legal processes of any jurisdiction or authority.

Creative Commons is not a party to its public licenses. Notwithstanding, Creative Commons may elect to apply one of its public licenses to material it publishes and in those instances will be considered the “Licensor.” The text of the Creative Commons public licenses is dedicated to the public domain under the CC0 Public Domain Dedication. Except for the limited purpose of indicating that material is shared under a Creative Commons public license or as otherwise permitted by the Creative Commons policies published at creativecommons.org/policies, Creative Commons does not authorize the use of the trademark "Creative Commons" or any other trademark or logo of Creative Commons without its prior written consent including, without limitation, in connection with any unauthorized modifications to any of its public licenses or any other arrangements, understandings, or agreements concerning use of licensed material. For the avoidance of doubt, this paragraph does not form part of the public licenses.

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