http://www.emaxhealth.com/11306/caution-advised-rheumatoid-arthritis-patients-considering-hip-or-knee-replacement
Victims of rheumatoid arthritis can develop
problems with their joints throughout the body, including the knee and hip.
These joints can be replaced with an artificial one with a procedure known as
arthroplasty. Researchers
affiliated with the University of Toronto (Toronto, Ontario, Canada)
conducted a study to evaluate the complication rate of a total hip or knee arthroplasty among
patients with rheumatoid arthritis, compared to patients with osteoarthritis.
They published their findings online on November 28 in the journal Arthritis &
Rheumatism.
The researchers noted that most of the evidence
regarding complications following total hip arthroplasty and total knee
arthroplasty is based on studies of patients with osteoarthritis; thus, little
information regarding the outcomes in patients with rheumatoid arthritis has
been published. Therefore, they conducted a study with the objective of
reviewing the current evidence regarding rates of total hip and knee
arthroplasty complications in rheumatoid arthritis patients compared to
osteoarthritis patients.
The researchers reviewed data from Medline, EMBase,
Cinahl, Web of Science, and reference lists of articles. They included reports
published between 1990 and 2011 that described studies of primary total joint
arthroplasty of the hip or knee and contained information on outcomes in 200 or
more rheumatoid arthritis and osteoarthritis joints. Outcomes of interest
included revision, hip dislocation, infection, 90-day mortality, and venous
thromboembolic (blood clot) events. Two reviewers independently evaluated each
study for quality and extracted data. Where appropriate, meta-analysis was
performed; if this was not possible, the level of evidence was assessed
qualitatively.
The review comprised 40 studies. The investigators found that
patients with rheumatoid arthritis are at increased risk of dislocation
following a total hip arthroplasty (2.16 times greater risk). In
addition, the found fair evidence to support the concept that risk of infection and risk of
early revision following total knee arthroplasty are increased in rheumatoid
arthritis, compared to osteoarthritis. There was no evidence of any
differences in rates of revision at later time points, 90-day mortality, or
rates of venous thromboembolic events following total hip replacement or total
knee replacement in patients with rheumatoid arthritis versus osteoarthritis.
Rheumatoid arthritis was explicitly defined in only three studies (7.5%), and
only 11 studies (27.5%) included adjustment for covariates (i.e., age, sex, and
comorbidity
The researchers concluded that the findings of
their literature review and meta-analysis indicate that, compared to patients
with osteoarthritis, patients
with rheumatoid arthritis are at higher risk of dislocation following total hip
arthroplasty and higher risk of infection following total knee arthroplasty.
Arthritis is inflammation of one or more joints,
which results in pain, swelling, stiffness, and limited movement. There are
over 100 different types of arthritis. Rheumatoid arthritis is considered an
autoimmune disease. The body's immune system normally fights off foreign
substances, such as viruses. But in an autoimmune disease, the immune system
confuses healthy tissue for foreign substances. As a result, the body attacks
itself. Osteoarthritis is related to aging. In osteoarthritis, the cushioning
(cartilage) between the bones wears away in the joints. As osteoarthritis gets
worse, the cartilage disappears and bone rubs on bone. Bony spurs or growths
usually form around the joint. The ligaments and muscles around the joint
loosen and become weaker.
