TAILIEUCHUNG - ARTHROPLASTY UPDATE_2

New technologies, developments in implant design and advances in surgical technique have improved outcomes after joint replacement and decreased rate of complications. It is not a surprise that the number of arthroplasties increases steadily every year and nowadays more than one million patients undergo the procedure annually worldwide. This book is a sequel of a successful series dedicated to one of the fastest growing fields in orthopedics - arthroplasty. | Section 4 Results of Arthroplasty by Etiology Chapter 13 Hip and Knee Arthroplasty in the Patient with Inflammatory Arthritis Andrew Gordon Hosam E. Matar and J. Mark Wilkinson Additional information is available at the end of the chapter http 54743 1. Introduction The term inflammatory arthritis refers to an inflammatory arthropathy in patients suffering from one of a number of chronic inflammatory conditions including rheumatoid arthritis RA and the seronegative spondyloarthropathies of ankylosing spondylitis AS psoriatic arthritis PsA spondyloarthritis associated with inflammatory bowel disease and undifferentiated spondyloarthritis. This chapter will focus on a review of the surgical management of patients with RA AS and PsA as these represent the most common of the inflammatory arthropathies. Knowledge of the inflammatory arthritidies is important for lower limb arthroplasty surgeons as awareness of both the local changes within the affected joints and how extra-articular manifestations can adversely affect anaesthesia surgery and rehabilitation is necessary to ensure good surgical outcomes. In addition to the local and systemic manifestations of the inflammatory diseases patients may be prescribed multiple medications including disease modifying anti-rheumatic drugs DMARDs or biological therapies that may affect the local surgical site or affect the patient systemically and have an impact on rehabilitation and patient outcome. In addition quality of life and functional outcome of patients with chronic inflammatory arthropathies may also be reduced compared to simple osteoarthritis because of the chronicity and systemic nature of the inflammatory disease. Finally the choice of implant and the method of fixation may affect implant survival and revision burden. The term inflammatory arthropathy covers a wide spectrum of diseases which ultimately manifest themselves with joint destruction systemic features and disability. In the following .

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