Artroplastia reversa de hombro en pacientes con artritis reumatoide: una revisión sistemática

http://www.lesionesdeportivas.com.mx/academia/artroplastia-reversa-de-hombro-en-pacientes-con-artritis-reumatoide-una-revision-sistematica/

Reverse Shoulder Arthroplasty in Patients with Rheumatoid Arthritis: A Systematic Review

Fuente

Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28861200

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5567028/

https://synapse.koreamed.org/DOIx.php?id=10.4055/cios.2017.9.3.325

De:

Cho CH1,Kim DH1,Song KS1.

Clin Orthop Surg.

2017 Sep;9(3):325-331. doi: 10.4055/cios.2017.9.3.325. Epub 2017 Aug 4.

Todos los derechos reservados para:

Copyright and License information ▼

Received 2016 Jun 30; Accepted 2017 Jun 4.

Copyright

© 2017 by The Korean Orthopaedic AssociationThis is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

BACKGROUND:

There are limited data available regarding the results of reverse shoulder arthroplasty (RSA) in patients with rheumatoid arthritis (RA). We performed a systematic review of the literature to investigate the radiological and clinical outcomes after RSA in patients with RA.

CONCLUSIONS:

RSA in RA showed similar short- to mid-term results without higher complication rates as compared to RSA in cuff tear arthropathy. Although RSA can be considered a reliable treatment option in patients with RA, further large-scale studies are required to determine the long-term survival of the implant.

KEYWORDS:

Complication; Outcome; Reverse shoulder arthroplasty; Rheumatoid arthritis

Resumen

ANTECEDENTES:
Hay pocos datos disponibles sobre los resultados de la artroplastia reversa de hombro (RSA) en pacientes con artritis reumatoide (AR). Se realizó una revisión sistemática de la literatura para investigar los resultados radiológicos y clínicos después de RSA en pacientes con AR.

CONCLUSIONES:
RSA en la AR mostraron resultados similares a corto y mediano plazo sin mayores tasas de complicaciones en comparación con RSA en la artropatía del desgarro del manguito. Aunque RSA puede considerarse una opción de tratamiento confiable en pacientes con AR, se requieren estudios adicionales a gran escala para determinar la supervivencia a largo plazo del implante.

PALABRAS CLAVE:
Complicación; Resultado; Artroplastia reversa del hombro; Artritis reumatoide

PMID:  28861200  PMCID:  PMC5567028   DOI:   10.4055/cios.2017.9.3.325

Free PMC Article

#Artroplastia reversa del hombro#Artritis reumatoide

Dolor de espalda baja en artritis reumatoide

http://www.cirugiavertebral.com.mx/academia/dolor-de-espalda-baja-en-artritis-reumatoide/

Low back pain in rheumatoid arthritis

Fuente

Este artículo es publicado originalmente en:

https://www.ncbi.nlm.nih.gov/pubmed/28875320

https://link.springer.com/article/10.1007%2Fs00393-017-0363-8

De:

Kothe R1.

Z Rheumatol.

2017 Sep 5. doi: 10.1007/s00393-017-0363-8. [Epub ahead of print]

Todos los derechos reservados para:

Copyright information

© Springer Medizin Verlag GmbH 2017

Abstract

Low back pain (LBP) in patients with rheumatoid arthritis (RA) has so far been of little concern in clinical investigations. The main focus of scientific publications on spinal problems in RA was the cervical spine. In a recent study, we could demonstrate that LBP in RA patients leads to a significantly higher degree of disability and depression as well as to a reduction in quality of life compared to RA patients without LBP. If there is a specific reason for the additional symptom of LBP, such as spinal stenosis or segmental instability, surgical treatment may be indicated to improve disability and quality of life. For a successful outcome of spinal surgery it is important to address the specific aspects of RA patients, such as poor bone quality and the immunosuppressive effect of antirheumatic drug treatment. Whenever possible, minimally invasivesurgical techniques should be used and the immunosuppressive medication should be stopped before surgery.

KEYWORDS:

Function; Lumbar spinal canal stenosis; Lumbar spine; Quality of life; Surgical procedures

Resumen

El dolor lumbar (LBP) en pacientes con artritis reumatoide (RA) hasta ahora ha sido de poca preocupación en las investigaciones clínicas. El foco principal de las publicaciones científicas sobre los problemas de la columna vertebral en la AR fue la columna cervical. En un estudio reciente, podríamos demostrar que la LBP en pacientes con AR conduce a un grado significativamente mayor de discapacidad y depresión, así como a una reducción en la calidad de vida en comparación con los pacientes con AR sin LBP. Si hay una razón específica para el síntoma adicional de LBP, como la estenosis espinal o la inestabilidad segmentaria, el tratamiento quirúrgico puede ser indicado para mejorar la discapacidad y la calidad de vida. Para un resultado exitoso de la cirugía de columna es importante abordar los aspectos específicos de los pacientes con AR, como la mala calidad ósea y el efecto inmunosupresor del tratamiento antirreumático. Siempre que sea posible, deben usarse técnicas quirúrgicas mínimamente invasivas y la medicación inmunosupresora debe detenerse antes de la cirugía.

PALABRAS CLAVE:
Función; Estenosis del canal espinal lumbar; Espina lumbar; Calidad de vida; Procedimientos quirúrgicos

PMID:  28875320   DOI:  

10.1007/s00393-017-0363-8

#conducto lumbar estrecho#columna lumbar#calidad de vida

Para prevenir la artritis reumatoide, mira más allá de las articulaciones a las encías

http://www.manoytrauma.com.mx/academia/para-prevenir-la-artritis-reumatoide-mira-mas-alla-de-las-articulaciones-a-las-encias/

To Prevent Rheumatoid Arthritis, Look Past the Joints to the Gums

Fuente
Este artículo es originalmente publicado en:

https://www.ncbi.nlm.nih.gov/pubmed/28273301

http://jamanetwork.com/journals/jama/article-abstract/2610358

De:

Abbasi J

.

JAMA.

2017 Mar 28;317(12):1201-1202. doi: 10.1001/jama.2017.0764.

Todos los derechos reservados para:

© 2017 American Medical Association. All Rights Reserved.

The findings, published in Science Translational Medicine late last year, appear to confirm something that’s been suspected for at least a century: In some cases, gum-disease causing oral bacteria may set off a cascade of events that leads to the autoimmune form of arthritis.

Los resultados, publicados en Science Translational Medicine a finales del año pasado, parecen confirmar algo que se sospecha durante al menos un siglo: En algunos casos, la enfermedad de las encías causada por bacterias orales puede desencadenar una cascada de eventos que conduce a la forma autoinmune de la artritis .

#artritis reumatoide#encias#bacterias orales#articulaciones

La artritis reumatoide en la columna cervical

http://www.ortopediaycolumna.com.mx/columna/la-artritis-reumatoide-en-la-columna-cervical/

Cervical Spine in Rheumatoid Arthritis

Fuente
Este artículo es originalmente publicado en:

https://youtu.be/t-NNF5IHJfI

De y Todos los derechos reservados para:

Courtesy: Prof Nabil Ebraheim,

University of Toledo, Ohio, USA

Dr. Ebraheim educational animated video illustrates spine concepts associated the cervical spine – rheumatoid arthritis.
Cervical spine involvement occurs in about 90% of the patients with rheumatoid arthritis.
All rheumatoid arthritis patients should have cervical spine examination.
Start with getting cervical spine x-rays, because this helps to diagnose atlantoaxial instability.
Early aggressive medical treatment can decrease this risk.
C1-C2 instability is common and can occur in up to 80%.
It occurs due to transverse ligament pathology.
So you will need to get flexion extension views in patients with rheumatoid arthritis, especially preoperative x-rays, and if it looks bad, you have to stabilize the spine before doing elective total hip or total knee procedures.
Discover the C1-C2 instability and fix it first before doing elective total hip procedure.
You see in the x-rays the Atlanto Dental Interval: A.D.I., if it was more than 3.5 mm that means instability of the upper cervical spine may be present.
If it is more than 7 mm it means disruption of the alar ligament, these patients can have cervical spine myelopathy.
The A.D.I. is an unreliable predictor of paralysis.
The posterior atlanto dental interval is a better predicting test, it can predict the spinal cord injury better.
If the posterior A.D.I. is less than 14 mm it can predict spinal cord injury, get an MRI.
The surgery is done if the A.D.I. is more than 10mm or if the P.A.D.I. is less than 14mm, the operation is C1-C2 fusion.
Clinically: the C1-C2 instability could give neck pain, headache, and myelopathy with abnormal gait, paresthesia and difficulty in fine motor control.
Basilar Invagination: 
Occur in about 40% of the patients with rheumatoid arthritis, basilar invagination is superior migration of the odontoid so the tip of the odontoid is above the foramen magnum; in this case you do occiput to C2 fusion, plus or minus odontoid resection.
The Subaxial Subluxation:
Occur in about 20% of the patients.
Indication of surgery is neurological compromise.
The space available for the cord is less than 14 mm then do posterior fusion surgery; surgery is usually not successful in severe types of neurological impairment.
When do you do surgery in rheumatoid arthritis?
You do it if there is:
• Severe pain
• Neurological deficit
• X-ray showing that the P.A.D.I. is less than 14mm 
• Superior odontoid migration
• Subaxial subluxation and the sagittal canal diameter is less than 14 mm.
If the posterior atlanto- dental interval (P.A.D.I.) is more than 14 mm, the patient will demonstrate significant motor recovery after surgery.

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#artritis reumatoide#columna cervical