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J Wrist Surg 2018; 07(03): 186-190
DOI: 10.1055/s-0038-1639508
Special Review: Wrist Arthroscopy in Juvenile Idiopathic Arthritis
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Wrist Arthroscopy in Juvenile Idiopathic Arthritis: A Review of Current Literature and Future Implications

P. V. Vermaak
1   Department of Plastic and Reconstructive Surgery, Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
,
T. R. Southwood
1   Department of Plastic and Reconstructive Surgery, Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
,
T. R. Lindau
2   Pulvertaft Hand Centre, Derby, United Kingdom
,
A. Jester
1   Department of Plastic and Reconstructive Surgery, Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
,
K. Oestreich
1   Department of Plastic and Reconstructive Surgery, Birmingham Women's and Children's Hospital, Birmingham, United Kingdom
› Author Affiliations Funding None.
Further Information

Publication History

30 October 2017

21 February 2018

Publication Date:
13 April 2018 (online)

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Abstract

Introduction Juvenile Idiopathic Arthritis (JIA) is the most common rheumatological condition in children and frequently affects the wrist. The roles for wrist arthroscopy and arthroscopic synovectomy (AS) in JIA are unclear. Our aim was to find the current evidence supporting its use.

Methods Systematic literature review of relevant publications from 1990 to present in the Cochrane Library, Clinical Knowledge Summaries, DynaMed, PEMSoft, NICE Guidance, MEDLINE, EMBASE, and PubMed.

Results We found no publications detailing the use of arthroscopy or AS specifically in patients with JIA involving the wrist. There is evidence that AS reduces pain, improves function, and induces remission in patients with rheumatoid arthritis resistant to medical management.

Discussion and Conclusion Although there is paucity in evidence for the use of AS in the wrists of patients with JIA, studies suggest it to be safe and effective, and could be applied to patients with refractive JIA. It is possible that early identification of patients suffering from JIA with extensive joint destruction and little symptoms could benefit from AS, delaying joint destruction and preserving function.

Keywords

juvenile idiopathic arthritis - wrist - arthroscopy - synovectomy

Note

This study was presented at the 10th World Symposium on Congenital Malformations of the Hand and Upper Limb 2015, May 7–9, Rotterdam, The Netherlands.


 

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