Total Joint Arthroplasty in Patients With Rheumatoid Arthritis: A United States Experience From 1992 Through 2005
Section snippets
Data Source
Maintained by the Agency for Healthcare Research and Quality [17], the NIS is the largest all-payer, inpatient care, stratified survey of US hospitals [17]. It contains a representative 20% sample of hospitals and tracks approximately 8 million hospital stays each year. The hospitals within the sampling frame are stratified according to region, location, teaching status, and number of beds. All discharge records from each of the selected hospitals are collected each year. For example, in 2007,
Total Knee Arthroplasty
There were 4 164 465 hospitalizations associated with primary TKA, 153 501 (3.7%) of which were associated with a diagnosis of RA (Table 1). The number of cases of primary TKA increased over time in the general population and in patients with RA (Fig. 1, Fig. 2). The incidence of primary TKA was significantly lower among those with RA than in the general population (P < .0001). In all patients, the incidence of primary TKA was significantly higher in females than in males (P < .0001) and
Discussion
In the United States, although the absolute number of primary TJA procedures from 1992 through 2005 increased in both the general population and in the patients with RA, the population-adjusted rates of these procedures were significantly lower in patients with RA. This finding has several important implications.
Studies from Sweden have reported a decrease in lower limb procedures in patients with RA between 1987 and 2001 [13] and a decrease in upper limb procedures between 1998 and 2004 [12].
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Cited by (30)
Shoulder arthroplasty trends in patients with rheumatoid arthritis receiving disease-modifying antirheumatic drug therapy
2023, Seminars in Arthroplasty JSESRisk of Total Knee and Hip Arthroplasty in Patients With Rheumatoid Arthritis: A 12-Year Retrospective Cohort Study of 65,898 Patients
2020, Journal of ArthroplastyCitation Excerpt :Previous studies based on population in the United States and Europe have described the prevalence trends and demographic risk of patients with RA undergoing TJA, whereas risks in population of China or Taiwan were not widely documented yet. Among the studies, heterogeneity was observed, especially between early and recent studies [26–30], indicating the need for TJA in patients with RA has plateaued over time and a turning point in the TJA incidence trajectory. Moreover, a study conducted by Hekmat et al [15] reported a significant decrease in the incidence of THA in patients with RA after 2001.
Bilateral Total Hip and Knee Arthroplasties: Average 10-Year Follow-Up
2017, Journal of ArthroplastyCitation Excerpt :Nevertheless, we believe it was appropriate to include both scoring systems in this study. Based on the report of Jain et al [18], disease modifying antirheumatic medications have slowed the disease progression of RA, helped to preserve function and prevent joint damage, and have led to a world-wide decrease in the percentage of RA patients requiring elective total joint arthroplasty. In addition, the number of people affected with symptomatic OA, including the hip and knee, is increasing because of the aging of the population and the obesity epidemic [19].
Outcomes of total shoulder arthroplasty in patients younger than 65 years: a systematic review
2017, Journal of Shoulder and Elbow SurgeryCitation Excerpt :Several of the included studies also include heterogeneous groups of patients, with the early reports having a large number of patients with rheumatoid arthritis. Because of the improved medical management of rheumatoid arthritis, multiple reports have shown a decreased or stabilized rate of arthroplasty in rheumatoid patients vs. the increased rates seen in the general population.9,20,34 Given these findings, the early studies on TSA in the young may not be applicable to the current treatment trends.
The Conflict of Interest statement associated with this article can be found at doi:10.1016/j.arth.2011.12.027.