# Timely Shaver Treatment Removes Chronic Tophaceous Mass Improve Surgical Outcomes

## TL;DR

Surgery using a shaver technique improves outcomes for chronic gout lesions, especially when done before infection and for upper body lesions.

## Contribution

The study introduces insights into optimal timing and location for shaver-assisted surgery in chronic tophus treatment.

## Key findings

- Surgery before tophus infection reduces hospital stay and healing time.
- Upper extremity lesions have better outcomes than lower extremity lesions.
- Factors like age or uricemia do not affect surgical outcomes.

## Abstract

Background: Current treatments with urate-lowering therapy (ULT) are effective for most patients with gout. However, approximately 10% of these patients do not respond well to ULT and develop chronic tophus lesions.

Objective: This study aimed to evaluate the efficacy of surgery involving the shaver technique against chronic tophus lesions.

Methods: This single-center, retrospective cohort study included 217 patients who had cumulatively undergone 303 shaver-assisted procedures between 2002 and 2018. Surgical outcomes were assessed in terms of the length of hospital stay (LOS) and wound healing time.

Results: LOS and wound healing time were longer in patients with a preoperative tophus infection and lower extremity lesions than in those without infection and with upper extremity lesions (respectively, LOS: 12.7 vs. 8.6 days; wound healing time: 22.7 vs. 16.3 days). However, factors such as age, sex, body mass index, renal function, or uricemia level exerted no significant effect on surgical outcomes.

Conclusion: Surgery involving the shaver technique should be performed before tophus infection. Clinical outcomes tend to be better for upper extremity lesions than for lower extremity lesions.