Objective Although new treatments for rheumatoid arthritis (RA) are extremely effective in preventing disease progression, rates of total knee replacement (TKR) continue to rise. The ongoing need for TKR is problematic, especially as functional outcomes have been reported to be worse than in patients with osteoarthritis (OA). The purpose of this study is to assess pain, function, and quality of life 2 years after TKR in a contemporary RA patients, compared to patients with OA. Methods Primary TKR cases enrolled between 5/1/2007 and 7/1/2010 in a single institution TKR registry were eligible for this study. Validated RA cases were compared to OA at baseline and at 2-years. Results We identified 4,456 eligible TKRs, including 136 RA. Compared to OA, RA TKR had significantly worse pre-operative WOMAC pain (55.9 vs. 46.6; p-value<0.0001) and function (58.7 vs. 47.3; p-value<0.0001) , however there were no differences at 2 years. Within RA, there was no difference for patients who used biologic DMARDs vs. those who did not in pain (p-value= 0.41) or function (p-value= 0.39) at 2 years. In a multivariate regression, controlling for multiple potential confounders, there was no independent association of RA with 2-year pain (p-value=0.18) or function (p-value=0.71).Satisfaction was high for both RA and OA. Conclusion RA patients undergoing primary TKR have excellent 2-year outcomes, comparable to OA, in spite of worse pre-operative pain and function. In this contemporary cohort, RA is not an independent risk factor for poor outcomes.

Contemporary patients with RA have significant improvements in pain and function after THR, but higher proportions have worse 2-year pain and function. In addition, RA is an independent predictor of 2-year pain and poor function after THR, despite high use of disease-modifying therapy.

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Objective Outcomes of total hip arthroplasty (THA) in patients with psoriasis have been poorly studied. This study was undertaken to assess whether patients with psoriatic arthritis (PsA) or those with cutaneous psoriasis (PsC) without evidence of inflammatory joint disease are at an increased risk for worse outcomes after THA as compared to patients with osteoarthritis (OA). Methods Among subjects in a prospective THA registry, PsA and PsC cases were identified by International Classification of Diseases, Ninth Revision codes, and all cases were matched with patients with OA as controls. Analyses were performed to identify predictors of poor postoperative pain or function. Results Of the 289 potential cases of PsA or PsC, 63 with PsA and 153 with PsC were validated. Self‐report data were available postoperatively from 75% of PsA patients, 69% of PsC patients, and 94% of OA controls. In total, 51% of PsA patients and 56% of PsC patients were male, compared to 45% of OA controls (P = 0.04). Body mass index was higher in those with PsA or PsC (P = 0.002 versus controls). There were no differences in race or education between the 3 groups. PsA patients and PsC patients had more comorbidities than OA controls. PsA patients were more likely than PsC patients and OA controls to be current or previous smokers. Moreover, 54% of PsA patients were being treated with biologics or nonbiologic disease‐modifying antirheumatic drugs, compared to 8% of PsC patients. There were no significant differences in pre‐ or postoperative Western Ontario and McMaster Universities OA Index scores for pain or function between the 3 groups. Short‐Form 36 mental component summary scores were significantly better in the OA controls, both pre‐ and postoperatively (P = 0.006 and P < 0.001, respectively, versus PsA or PsC). EuroQol 5‐domain health‐related quality of life scores were significantly worse postoperatively for those with PsA or PsC (P < 0.0001 versus OA controls). In regression analyses, neither PsA nor PsC were risk factors for worse THA outcomes. Satisfaction with the outcomes of THA was similarly high among all 3 groups (P = 0.54). Conclusion Neither PsA nor PsC are risk factors for poor outcomes after THA. This is important information to convey to patients with either PsA or PsC who are contemplating surgical intervention with THA.

cartilage degeneration, subchondral sclerosis, and osteophyte formation in both rat and rabbit ACLT and Meniscectomy models. The underlying initiating mechanism in surgically-induced OA models was found to be the altered mechanical loading which is the same initiating cause in human secondary OA. Conclusions: All animal models and induction mechanisms result in morphological changes that resemble human pathology in some stages of the disease. Differences are particularly in time of onset of the disease and the speed of disease progression. Moreover, molecular mechanisms of joint structural damage are distinct in different animal models and induction mechanisms. Each animal model and induction mechanism used in OA research has its own advantages and disadvantages. Thus, choosing the best model which mimics human etiology and addresses the aim of the study seems to be a crucial step in conducting research in this area. Hopefully, the present study provides a framework for choosing the best animal model and paves the way for the development of novel disease-modifying agents.