New Study Challenges Rheumatoid Arthritis Myth

Patients with rheumatoid arthritis (RA) who undergo hip and knee replacements are just as pleased with the results as are patients who have osteoarthritis (OA) and undergo the same surgeries, according to studies presented at the European League Against Rheumatism’s annual congress. The studies found that RA patients were as likely as OA patients to see improvements in pain and function after either surgery, even though some RA patients did not do as well as OA patients after hip surgery, wrote Jennifer Davis for Arthritis Today.

The findings refute earlier beliefs that RA patients who undergo joint replacement surgery have less favorable outcomes than do OA patients. Davis points out that many of the studies on which this idea is based were done before biologics were in widespread use.

“RA patients were just as likely to have significant improvement and on the questions of satisfaction, they were as satisfied. They were doing much better than when they went into the surgery, ” explains lead author of both studies Susan M. Goodman, M.D., a rheumatologist at Hospital for Special Surgery in New York City. Davis quotes Goodman as saying, “The likelihood of not doing well is higher for that RA group even though their absolute improvements are the same. They improve and are very satisfied with it—they just aren’t doing as well as OA patients.”

The knee study was based on records of 178 RA patients and 5, 206 OA patients from the Hospital For Special Surgery Replacement Registry who had total knee replacement surgery. While RA patients had worse pain and function before the surgery, after the procedure they had similar outcomes and satisfaction. Both the knee and hip studies documented patient’s pain, functional abilities and satisfaction before surgery as well as two years later.

Davis reported that the study also looked at patients who had revision knee replacement surgery. The 32 RA patients and 342 OA patients studied had similar pain and function before the second surgery. But two years later, RA patients were doing better than OA patients and 90% of the RA patients were satisfied with the outcome compared with 67% of the OA patients.

The situation with hip replacement patients was another matter. Among 202 RA patients and 5, 810 OA patients having hip replacements, the RA patients had worse function and greater pain before surgery. Two years later, all patients in both groups showed a 10 point improvement in their function scores. However, 18% of the RA patients still had poor function compared to only 4% of OA patients.