Review Question - QID 6587

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Rheumatoid Arthritis QID: 6587 (SAE08UE.25)

QID 6587 (Type "6587" in App Search)

A 49-year-old woman with serologically proven rheumatoid arthritis has Larsen grade II radiographic changes in the elbow. Examination reveals a preoperative arc of flexion of less than 90 degrees and there is no instability. Nonsurgical management has failed to provide relief. What is the best treatment option?

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Semiconstrained total elbow arthroplasty

32%

26/80

Unlinked total elbow arthroplasty

6/80

Fascial arthroplasty

7/80

Open synovectomy

18%

14/80

Arthroscopic synovectomy

31%

25/80

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Larsen grade I and II rheumatoid arthritis is best treated with synovectomy with arthroplasty reserved for later stages, especially in younger patients. Open synovectomy with or without a radial head excision has yielded good results for pain and function, with arthroscopic synovectomies yielding similar results. Arthroscopic synovectomy has been shown to be more effective in restoring function in patients with a flexion arc of less than 90 degrees.