Introduction:
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of childhood and often persists into adulthood, leading to progressive joint destruction, disability, and reduced quality of life. Despite advances in pharmacological treatment, including biologic therapies, some patients still require orthopedic surgical interventions such as synovectomy and joint arthroplasty. The aim of this study was to evaluate the subjective physical and psychological functioning of adult patients with JIA who underwent knee synovectomy and/or hip and knee arthroplasty before the age of 40.

Material and methods:
The study included 80 adult patients with JIA (56 women, 24 men) who underwent orthopedic surgery involving knee synovectomy and/or arthroplasty of large lower limb joints. Mean age at disease onset was 10 years, and mean disease duration at assessment was 25 years. Functional disability was assessed using the Health Assessment Questionnaire Disability Index, quality of life using the World Health Organization Quality of Life-BREF questionnaire, and pain intensity using the Visual Analogue Scale (VAS). Additional data included disease activity, pharmacological treatment, use of mobility aids, independence in daily activities, and psychological well-being.

Results:
Persistent disease activity with periods of remission was reported by 55% of patients, while only 21% remained in remission for longer than two years. Before surgery, 86% of patients required mobility aids, compared to 13% after surgery. Severe preoperative pain (VAS 8–10) decreased significantly after surgery (VAS 0–2). Functional independence improved markedly, and 77% of patients reported resolution of major limitations in daily activities. Psychological well-being also improved; 77% felt ready to continue their education or seek better employment opportunities. Depression and anxiety disorders were diagnosed in 12.5% of patients.

Conclusions:
Orthopedic procedures were associated with improvements in mobility, pain control, and quality of life in adult patients with JIA. However, most patients still presented with active disease and long-term disability, indicating the need for continued multidisciplinary care and long-term monitoring of surgical outcomes.