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Rheumatoid Arthritis Does Not Increase Risk of Short-term Adverse Events after Total Knee Arthroplasty: A Retrospective Case-control Study. - PubMed - NCBI

Rheumatoid Arthritis Does Not Increase Risk of Short-term Adverse Events after Total Knee Arthroplasty: A Retrospective Case-control Study. - PubMed - NCBI



 2015 Jul;42(7):1123-30. doi: 10.3899/jrheum.141251. Epub 2015 May 1.

Rheumatoid Arthritis Does Not Increase Risk of Short-term Adverse Events after Total Knee Arthroplasty: A Retrospective Case-control Study.

Abstract

OBJECTIVE:

More adverse events (AE) are reported after total knee arthroplasty (TKA) for patients with rheumatoid arthritis (RA) than for patients with osteoarthritis (OA). This study evaluates 6-month postoperative AE in a high-volume center in a contemporary RA cohort.

METHODS:

Patients with RA in an institutional registry (2007-2010) were studied. AE were identified by self-report and review of office and hospital charts. Subjects with RA were matched to 2 with OA by age, sex, and procedure. RA-specific surgical volume was determined. Baseline characteristics and AE were compared and analyzed.

RESULTS:

There were 159 RA TKA and 318 OA. Of the patients with RA, 88.0% were women, 24.5% received corticosteroids, 41.5% received biologics, and 67% received nonbiologic disease-modifying antirheumatic drugs (DMARD). There was no difference in comorbidities. RA-specific surgical volume was high; 64% of cases were performed by surgeons with ≥ 20 RA cases during the study period. Patients with RA had worse baseline pain and function and lower perceived health status (EQ-5D 0.59 vs 0.65, p < 0.01). There were no deep infections in either group and no difference in superficial infection (9.4% RA vs 10.1% OA, p = 0.82), myocardial infarction (0.7% RA vs 0% OA, p = 0.33), or thromboembolism (1.3% RA vs 0.6% OA, p = 0.60).

CONCLUSION:

In a high-volume center, with high RA-specific experience, RA does not increase postoperative AE. Despite worse preoperative function and high steroid and DMARD use, complications were not increased. However, further study to determine generalizability is needed.

KEYWORDS:

DISEASE-MODIFYING ANTIRHEUMATIC DRUGS; KNEE; OSTEOARTHRITIS; RHEUMATOID ARTHRITIS; SURGERY

PMID:
 
25934825
 
PMCID:
 
PMC4756638
 
DOI:
 
10.3899/jrheum.141251

[PubMed - indexed for MEDLINE] 
Free PMC Article