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Who Does Better After Joint Replacement Surgery: Rheumatoid Arthritis or Osteoarthritis Patients?

By June 14, 2013

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Have you ever wondered how well rheumatoid arthritis patients do after joint replacement surgery compared to osteoarthritis patients? Researchers from the Hospital for Special Surgery (HSS) have the answer based on two new studies. The results are being presented at the annual meeting of the European League Against Rheumatism (EULAR).

Information for the studies was derived from the HSS Total Joint Replacement Registry which was started in 2007. The consensus had been that patients with rheumatoid arthritis had worse outcomes following joint replacement compared to osteoarthritis patients -- perhaps because they have more comorbidities or are sicker prior to surgery. But, as disease-modifying anti-rheumatic drugs (DMARDs) and biologic drugs allowed better control over rheumatoid arthritis, something changed. In the first HSS study, researchers identified 178 rheumatoid arthritis patients and 5,206 osteoarthritis patients who had total knee replacement. The rheumatoid arthritis patients had more pain and worse function before surgery compared to the osteoarthritis group -- but after surgery, the two groups had similar rates of satisfaction. The surgery leveled the playing field, so to speak. An analysis of rheumatoid arthritis and osteoarthritis patients who had revision (repeat) knee replacement surgery showed that rheumatoid arthritis patients actually did better (had less pain, better function, and greater satisfaction) than osteoarthritis patients.

The second study compared hip replacement surgery outcomes in 202 rheumatoid arthritis patients and 5,810 osteoarthritis patients. While function was significantly worse in rheumatoid arthritis patients before hip surgery, they showed significant improvement in function at two years post-op. Despite the improvement, it was still worse than what osteoarthritis patients achieved. Hip revision showed similar results. Researchers noted that many rheumatoid arthritis patients flare around 6 weeks post-op and that may interfere with their ability to do physical therapy after hip surgery. It may also be that rheumatoid arthritis patients wait too long to have hip replacement surgery.

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Tom Denham (stock.xchng)

June 16, 2013 at 12:21 pm
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