An Insight into Methods and Practices in Hip Arthroplasty in Patients with Rheumatoid Arthritis

Mosleh-shirazi, Mohammad Saeed; Ibrahim, Mazin; Pastides, Philip; Khan, Wasim; Rahman, Habib

doi:10.1155/2015/140143

Cited by 13 publications

(9 citation statements)

References 52 publications

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“…Since 1990 many studies are developed for surgical treatment correction of large joints damaged by RA and now this procedure is part of patient’s treatment [ 15 ]. With this achievement, the global orthopaedic community has increased the quality of patient’s life significantly with rheumatoid arthritis, and these methods are constantly improving [ 16 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence of Coxitis and its Correlation with Inflammatory Activity in Rheumatoid Arthritis

Bajraktari¹,

Krasniqi²,

Rexhepi³

et al. 2018

Open Access Maced J Med Sci

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BACKGROUND:Rheumatoid arthritis (RA) is an autoimmune inflammatory disease characterised by intra-articular and extra-articular manifestations but very rarely with coxitis.AIM:This study aimed to investigate the prevalence of coxitis, clinical changes, and its correlation with the parameters of inflammatory activity.METHODS:A cohort of 951 patients diagnosed with ACR/EULAR (American College of Rheumatology/European League against Rheumatism) 2010 criteria was enrolled in this prospective, observational and analytic research study. The CBC (Complete Blood Count), ESR (Erythrocyte sedimentation rate), CRP(C - reactive protein), Anti CCP (Antibodies to cyclic citrullinated peptides), X-ray examination of palms and pelvis, and the activity of the disease as measured by DAS - 28 (28 - joint disease activity score) were carried out in all subjects. Independent samples t-test was used to compare the group’s characteristics, whereas Pearson correlation test was used to analyse the correlation between study variables.RESULTS:Of the total number of the subjects, 730 (76.8 %) were females, whereas 221 (23.2%) were males. The average age was 51.3, y/o while the most of them were between 40 - 49 y/o (32.6%). The prevalence of coxitis was 14.2%, mostly found in males (19.46%). The echosonografic prevalence of changes was 21.45%, while the radiological changes were 16.3%; in both cases, the changes were more expressed in males. The analysis showed that inflammatory parameters were significantly higher in patients with coxitis.CONCLUSION:Coxitis has high economic cost because it ends up with a mandatory need for a total hip joint prosthesis. Thus the results of this study can serve to plan and initiate early preventive measures.

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Section: Discussionmentioning

confidence: 99%

Prevalence of Coxitis and its Correlation with Inflammatory Activity in Rheumatoid Arthritis

Bajraktari¹,

Krasniqi²,

Rexhepi³

et al. 2018

Open Access Maced J Med Sci

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“…RA has also been shown to increase the odds of developing implant-related complications after primary TKA. [31][32][33][34][35] Bone quality in patients with RA is generally poor and is due to the compounding effects of the inflammatory disease process in addition to disuse and chronic use of steroids. 36 Additionally, prostaglandins released by the rheumatoid synovium have also been implicated in direct subchondral bone resorption.…”

Section: Discussionmentioning

confidence: 99%

Perioperative Complications in Patients with Rheumatoid Arthritis Following Primary Total Knee Arthroplasty: An Analysis of 102,898 Patients

et al. 2019

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There are conflicting results regarding the impact of rheumatoid arthritis (RA) on total knee arthroplasty (TKA) outcomes. Therefore, the purpose of this study was to compare outcomes of patients with and without RA undergoing primary TKA. Specifically, we assessed (1) 90-day medical complications, (2) 90-day readmission rates, (3) short-term implant-related complications, (4) 1-year mortality, and (5) total global 90-day episode-of-care costs. The authors of the study hypothesize that RA would increase the rate of medical- and implant-related complications, readmission rates, and costs. A retrospective level of evidence III study was conducted using the Medicare standard analytical files from the PearlDiver database. Patients were queried using the International Classification of Disease, ninth revision codes. Patients with RA were randomly matched 1:1 to controls according to age, gender, and Charlson's comorbidity index. Two mutually exclusive cohorts were formed. Medical- and implant-related complications, readmission rates, and costs were analyzed and compared between the cohorts. Statistical analysis using logistic regression was performed calculating odds ratios (OR), 95% confidence intervals (95% CI), and their respective p-values. The query returned 102,898 patients with (n = 51,449) and without (n = 51,449) RA undergoing primary TKA within the Medicare database from 2005 to 2014. Patients with RA had greater odds of medical complications (OR: 2.08, 95% CI: 1.98–2.20, p < 0.001), implant complications (OR: 1.30, 95% CI: 1.24–1.36, p < 0.001), 1-year mortality (OR: 1.35, 95% CI: 0.68–2.70, p = 0.39), total 90-day episode-of-care costs ($16,605 vs. 15,716.53; p < 0.001), and 90-day readmission rates were similar between cohorts (OR: 1.08, 95% CI: 1.05–1.12, p < 0.001). RA increases postoperative complications and costs following primary TKA within Medicare patients. Comprehensive preoperative optimization for patients with a diagnosis of RA may mitigate perioperative complications, thus improving patient outcomes, and ultimately reducing episode-of-care costs.

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“…Patients with rheumatoid arthritis are at a high risk of postoperative surgical site infection, with prosthetic joint infections the most common (Mosleh-shirazi et al 2015). This is because many of these patients are on DMARDs and glucocorticoids which are immunosuppressants (Gualtierotti et al 2018).…”

Section: Postoperative Managementmentioning

confidence: 99%

Perioperative management of patients with rheumatoid arthritis undergoing orthopaedic surgery

Agarwal

Kamaraj

McDonnell

et al. 2019

Journal of Perioperative Practice

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Rheumatoid arthritis is an autoimmune disease which is characterised by systemic inflammation. In the recent decades, the advent of disease modifying anti-rheumatic drugs have reduced the need for orthopaedic procedures. However, there are numerous patients in which pharmacological treatment fails and these patients require surgical intervention. Complications can arise due to the underlying pathology and multitude of medications these patients can be on, specifically increased infection rates due to use of immunosuppressive agents. An understanding into the disease itself, as well as perioperative management, may improve overall patient outcomes and prevent future complications.

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An Insight into Methods and Practices in Hip Arthroplasty in Patients with Rheumatoid Arthritis

Cited by 13 publications

References 52 publications

Prevalence of Coxitis and its Correlation with Inflammatory Activity in Rheumatoid Arthritis

Prevalence of Coxitis and its Correlation with Inflammatory Activity in Rheumatoid Arthritis

Perioperative Complications in Patients with Rheumatoid Arthritis Following Primary Total Knee Arthroplasty: An Analysis of 102,898 Patients

Perioperative management of patients with rheumatoid arthritis undergoing orthopaedic surgery

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