Knee, Hip Replacement Outcomes Compared with Arthritis
(HealthDay News) – Patients with rheumatoid arthritis (RA) undergoing total knee replacement (TKR) have outcomes at two years similar to those seen in patients with osteoarthritis (OA); while for total hip replacement (THR), two-year pain and function is significantly worse for those with RA vs. OA, according to two studies presented at the annual meeting of the European League Against Rheumatism, held from June 12–15 in Madrid.
Susan M. Goodman, MD, and colleagues from the Hospital of Special Surgery in New York City, compared baseline and two-year outcomes of primary and revision TKR in patients with RA and OA. The researchers found that patients with RA and OA experienced similar clinically meaningful improvements in pain and function, and the number of patients with poor outcomes at two years was similar between the groups. In both groups, satisfaction was high. For those who underwent revision TKR, patients with RA experienced significantly less pain and better function at two years than did those with OA.
In a second study, Goodman and colleagues compared outcomes of primary and revision THR in RA and OA. The researchers found that patients with RA undergoing THR had significantly worse baseline and two-year Western Ontario and McMaster Universities Arthritis Index pain and function scores, with increased prevalence of poor pain and poor function at two years. Function was significantly worse and there was a two-fold increased prevalence of poor function at two years for RA patients undergoing revision THR.
"Many RA patients have a worsening or flare of their disease six weeks after surgery," Goodman said in a statement. "It may be that those patients aren't able to do their physical therapy because they are not feeling well, and maybe that contributes to poor outcomes down the road."