J Med Life Sci.  2023 Mar;20(1):32-37. 10.22730/jmls.2023.20.1.32.

Effect of rheumatoid arthritis on primary total knee arthroplasty and revision arthroplasty

• Jeong W
• Kwon OS
• Song SW

• KMID: 2561924
• DOI: http://doi.org/10.22730/jmls.2023.20.1.32

Abstract

The demand for total knee arthroplasty (TKA) is rapidly increasing worldwide. The most common indication for TKA is osteoarthritis (OA); however, some patients with rheumatoid arthritis (RA) also undergo TKA. This study aimed to investigate the effects of RA on TKA. Our findings revealed that patients with RA underwent TKA at a younger age than did patients with OA. However, contrary to the findings of pre-21st century studies, the average age of TKA among patients with RA was not significantly different from that of patients with OA. Additionally, patients with RA had a 1.5-fold higher risk of undergoing TKA. Although not statistically significant, patients with RA had a higher revision TKA rate, a shorter time until revision TKA, and underwent more revision TKAs due to infections than did patients with OA. An analysis of factors that affect revision TKA revealed that the risk of revision increased if the erythrocyte sedimentation rate and C-reactive protein levels were increased at the time of TKA. This study showed that patients with RA have a slightly higher risk of undergoing TKA than did patients with OA. Furthermore, the presence of inflammation at the time of TKA increases the risk of revision; therefore, inflammation should be adequately controlled before performing TKA.

Keyword

Arthritis; rheumatoid; Arthroplasty; replacement; knee; Reoperation