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Published in: Current Rheumatology Reports 1/2021

01-01-2021 | Gout | Crystal Arthritis (M Pillinger & M Toprover, Section Editors)

Beyond Medical Treatment: Surgical Treatment of Gout

Authors: Jonathan Carcione, Shari Bodofsky, Brian LaMoreaux, Naomi Schlesinger

Published in: Current Rheumatology Reports | Issue 1/2021

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Abstract

Purpose of Review

Medical 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 Findings

The 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 were found during surgery. The majority of the surgeries were performed in Asia and Europe.

Summary

Most 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.
Appendix
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Metadata
Title
Beyond Medical Treatment: Surgical Treatment of Gout
Authors
Jonathan Carcione
Shari Bodofsky
Brian LaMoreaux
Naomi Schlesinger
Publication date
01-01-2021
Publisher
Springer US
Keyword
Gout
Published in
Current Rheumatology Reports / Issue 1/2021
Print ISSN: 1523-3774
Electronic ISSN: 1534-6307
DOI
https://doi.org/10.1007/s11926-020-00969-6

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