Surgical treatment of juvenile rheumatoid arthritis.

Juvenile rheumatoid arthritis is rare and only affects a small number of children but can lead to severe crippling of adolescents or adults unless they are treated early. In this review the problems encountered in the surgical treatment, particularly those caused by skeletal stunting are discussed. The results of synovectomy of the knee and elbow are valuable procedures in suitably selected patients. Stapling of the knee in young children with genu valgum gave good correction in the majority. Soft tissue operation on the hip and knee in young children with severe deformities have given encouraging results. Complications and the results of reconstructive surgery for the hip and knee are discussed, and it was found that total joint replacement in these young patients with badly damaged hips is fully justified before they become chairbound.