TY - JOUR ID - 120849 TI - Should the surgical intervention of the hands and wrists of patients with rheumatoid arthritis be earlier? JO - International Journal of Medical Reviews JA - IJMR LA - en SN - 2345-525X AU - Fagundes, Thales Pardini AU - Moura, Fabiana Miranda AU - Castro, Ubiratan Brum AD - Department of Musculoskeletal System, Faculty of Medicine of Federal University of Minas Gerais, Belo Horizonte, Brazil Y1 - 2020 PY - 2020 VL - 7 IS - 4 SP - 136 EP - 139 KW - arthritis KW - Rheumatoid KW - Synovectomy KW - Arthrodesis KW - Tendon Transfer KW - Early Diagnosis KW - adult DO - 10.30491/ijmr.2020.225044.1090 N2 - Aim: Few studies have been published about early surgical treatment of Rheumatoid Arthritis (RA). This article has aimed to describe the main procedures that may be performed in the hands of subjects at early stages of this disease.  Methods: This research was a narrative review seeking comparative works in the Medline, LILACs and EMBASE databases.  Results: The publications showed good results associated with wrist synovectomy. There was a reduction in pain, greater patient satisfaction, and stabilization of the Larsen score. Synovectomy was indicated in these studies as an alternative procedure after three to four months of unsatisfactory clinical therapy. Another possibility of approaching these patients is the repair or transfer of ruptured tendons. Most studies have described this procedure in patients already with deformities secondary to RA and not in the initial phase of the disease. In this group of patients, the authors observed that the highest number of ruptures was associated with worse surgical outcomes. In most studies about wrists, radiolunate and RA were performed at more advanced stages, such as Larsen 3, and, even performed late, a clinical and radiological improvement was observed.  Conclusion: In this review, no studies with a high level of scientific evidence, testing early surgical interventions on the hands and wrists of patients with RA were found. Synovectomy, soft tissue repair, and arthrodesis are suggested as procedures that can be performed earlier than usual. UR - https://www.ijmedrev.com/article_120849.html L1 - https://www.ijmedrev.com/article_120849_5d10a54ddb12ef77115a1805888ba9fd.pdf ER -