SURGICAL EVALUATION OF INTERVENTIONS FOR REFRACTORY RHEUMATOID ARTHRITIS

Abstract

Introduction: Surgical evaluation of interventions for refractory rheumatoid arthritis is a topic of great relevance in the context of the management of this chronic autoimmune disease. Rheumatoid arthritis (RA) is characterized by joint inflammation, pain and stiffness, often leading to joint destruction and functional disability. When drug therapy is not sufficient to control symptoms and preserve joint function, surgery can be considered as a therapeutic option. Objective of Systematic Literature Review: The objective of this systematic review is to critically analyze the available scientific literature on surgical interventions for patients with refractory rheumatoid arthritis. We seek to identify the best surgical practices, considering effectiveness, safety and impact on patients' quality of life. Methodology (Based on the PRISMA Checklist): Identification of Studies: We carried out searches in the PubMed, Scielo and Web of Science databases. We used the following descriptors: "rheumatoid arthritis", "surgical intervention", "surgical treatment", "operation" and "refractory". We restricted the search to articles published in the last 10 years. Inclusion Criteria: Studies that investigated surgical interventions in patients with rheumatoid arthritis. Publications in English, Portuguese or Spanish. Studies that reported clinical, functional or radiological results. Exclusion Criteria: Studies with small samples (less than 20 patients). Isolated case reports. Studies without detailed description of surgical interventions. Results: We identified studies that addressed synovectomy, arthroplasty and other surgical techniques. Surgical interventions have demonstrated improvements in pain, joint function and quality of life. Adverse effects such as postoperative infections have also been reported. Conclusion: Surgical evaluation must be individualized, considering the severity of the disease and associated risks. The choice of surgical intervention must be based on scientific evidence and multidisciplinary discussion.