Beyond Medical Treatment: Surgical Treatment of Gout

AbstractPurpose of ReviewMedical treatment with urate-lowering therapy (ULT) is efficacious. A recent publication suggested that surgery in gout is more prevalent than previously reported. This revelation led us to review what is known about surgical treatment of gout.Recent FindingsThe Google Scholar database (January 1, 2014 –January 1, 2020) found 104 publications with a total of 169 gout patients, with an average disease duration of 6.7 years. Most (68%) were not on ULT. The mean pre-operative serum urate levels were 9.19 mg/dL. One hundred thirteen patients underwent tophi excision, while in 33 patients, tophi we re found during surgery. The majority of the surgeries were performed in Asia and Europe.SummaryMost patients were not taking ULT at the time of surgery, leading to hyperuricemia. This can result in tophi reformation post-surgery. The role of surgery should be a last-line treatment and until recently has only been demonstrated through case reports.
Source: Current Rheumatology Reports - Category: Rheumatology Source Type: research