Orthopedic Surgeries in Psoriatic Arthritis Increasing
Written by Editor   
Thursday, September 29, 2016 12:00 AM

Orthopedic surgical procedures are performed far more commonly today among patients with psoriatic arthritis (PsA) than in the past.  A total of 48.3% underwent at least one orthopedic surgical procedure, with a mean disease duration at the time of surgery of 1.58 years.  In contrast, in a study published in 1998, only 7% of patients with PsA had surgery to restore joint function, and after a mean disease duration of 13.9 years.

It is now recognized that the structural damage of PsA is similar in extent to that seen with rheumatoid arthritis. Moreover, in addition to the bone erosions and cartilage loss seen in rheumatoid arthritis, PsA patients can also develop joint ankylosis and severe osteolysis.

More of the joint-sacrificing procedures such as placement of prostheses involved the lower limbs. For instance, hip replacement and knee replacements. For all the joint-sacrificing procedures, patients’ mean age was 51.  On the nonjoint sacrificing procedures, the most common were diagnostic arthroscopies and meniscus operations.

Patients with asymmetric monoarticular or oligoarticular arthritis had the most surgeries. Among the potential reasons for the "remarkable differences" in the current rates of surgery compared with historical cohorts is the much more active early management of PsA to inhibit progression, including more prompt referral for surgery, researchers explained.

The findings underscore the importance of “early diagnosis and aggressive management of PsA from the very beginning" to minimize the need for surgery and maintain patients' quality of life.

Source: http://www.medpagetoday.com/Rheumatology/Arthritis/59894