"Wait until the acute condition quiets down." "Don't operate during the acute stage." These statements express the commonly accepted opinion about surgical procedures undertaken during the active stage of rheumatoid arthritis. The lack of success of fascia lata arthroplasty and of synovectomy when undertaken during the acute stage is the obvious reason for this prevailing opinion. The success of vitallium mold arthroplasty undertaken in spite of active disease has made us stop to analyze the pros and cons of operative treatment.
To relieve pain, to arrest the disease process and to preserve function are the aims of treatment of any acute condition of a joint. "Rest" is the principle of all so-called "conservative" nonoperative measures. As a rule, the "rest" treatment is successful in relieving pain, sooner or later; as a rule, the "rest treatment" is successful in arresting the disease process locally; when it comes to preserving function, the
SMITH-PETERSEN MN, AUFRANC OE, LARSON CB. USEFUL SURGICAL PROCEDURES FOR RHEUMATOID ARTHRITIS INVOLVING JOINTS OF THE UPPER EXTREMITY. Arch Surg. 1943;46(5):764–770. doi:10.1001/archsurg.1943.01220110180029