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Study finds more complications for patients with rheumatoid arthritis after TJA

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Compared with patients with osteoarthritis, patients with rheumatoid arthritis are more likely to have an increased risk of hip dislocation after total hip arthroplasty and an increased risk of infection and revision after total knee arthroplasty, according to Canadian researchers.

“Joint arthroplasty is successful in relieving the pain and disability caused by hip or knee arthritis,” Bheeshma Ravi, MD, from the University of Toronto and Women’s College Research Institute in Canada, stated in a press release. “While complication rates are low, there are some cases with serious consequences that include infection, joint dislocation, blood clots and even death.”

In a systematic review, Ravi and colleagues found that following total hip arthroplasty (THA), patients with rheumatoid arthritis (RA) had an overall 2.16 increased odds ratio for risk of dislocation compared to patients with osteoarthritis (OA), according to the abstract.

Among patients who had total knee arthroplasty (TKA), an analysis of three studies showed an increased risk of early revision in for patients with RA than in patients with OA, although the studies showed no difference in revision between the groups at 6 years to 10 years or beyond 10 years. Five studies showing infection rates in patients with RA all agreed that RA patients were more at risk for infection after TKA.

“Additional studies to confirm our findings are necessary and further investigation of possible reasons for differences in joint replacement complication rates between RA and OA patients is needed,” Ravi said.

Reference:

Ravi B. Arthritis Rheum. 2012;doi: 10.1002/art.37690.

Disclosure: One author of the study (Bogoch) received consulting and speaking fees from Eli Lilly, Proctor & Gamble, Merck Frosst Canada, Merck Sharpe & Dohme, Novartis Canada Ltd., the Alliance for Better Bone Health and has received grants from Amgen Canada, Novartis Canada Ltd., Warner-Chilcott and the Alliance for Better Bone Health.