title: 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.
authors.affiliation: Department of Orthopaedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, 10-22 Kawada, Shinjuku, Tokyo, 162-0054, Japan. smomohara@ior.twmu.ac.jp
authors.forename: Shigeki
authors.initials: S
authors.lastname: Momohara
authors.forename: Sakae
authors.initials: S
authors.lastname: Tanaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Nakamura
authors.forename: Junya
authors.initials: J
authors.lastname: Mibe
authors.forename: Takuji
authors.initials: T
authors.lastname: Iwamoto
authors.forename: Katsunori
authors.initials: K
authors.lastname: Ikari
authors.forename: Jinju
authors.initials: J
authors.lastname: Nishino
authors.forename: Yuho
authors.initials: Y
authors.lastname: Kadono
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Yasui
authors.forename: Kenji
authors.initials: K
authors.lastname: Takahashi
authors.forename: Kenji
authors.initials: K
authors.lastname: Takenouchi
authors.forename: Kenzo
authors.initials: K
authors.lastname: Hashizume
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Nakahara
authors.forename: Ayako
authors.initials: A
authors.lastname: Kubota
authors.forename: Takashi
authors.initials: T
authors.lastname: Nakamura
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Nishida
authors.forename: Toru
authors.initials: T
authors.lastname: Suguro
mesh_terms: D001172:Arthritis, Rheumatoid / Q000601:surgery*; D006801:Humans; D007564:Japan; D009985:Orthopedics / Q000639:trends*