Beyond Medical Treatment: Surgical Treatment of Gout

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Jonathan Carcione, Shari Bodofsky, Brian LaMoreaux & Naomi Schlesinger

Main idea: 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

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 the surgical treatment of gout.

Recent Findings

Google Scholar database 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. One hundred thirteen patients underwent tophi excision. In 33 patients, tophi were found during surgery.

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