Same-Day Surgery OK for OA Knees

For patients in a hurry, those who want to get their knee replacements over with in as short a time as possible, same-day bilateral knee replacement is a possibility. Does it matter to the surgeon what is ailing those sore knees?

While patients with rheumatoid arthritis (RA) are often sicker than are patients with osteoarthritis (OA), Mark Figgie, M.D., chief of the Surgical Arthritis Service at Hospital for Special Surgery, has found that patients with RA do just as well with same-day bilateral knee replacement as do OA patients, and with no higher complication rate.

According to American Medical Network, Figgie and his colleague, Allan E. Inglis, M.D., chair in Surgical Arthritis, analyzed data from 240 RA patients and 3, 680 OA patients who had bilateral knee replacement surgeries between 1998 and 2011. There were differences between the two groups. They found that more than 80% of the RA patients were women and that they were more likely to have heart disease, be on medications that suppress the immune system, be obese and were about five years younger than the OA patients.

Despite the fact that the RA group stayed in the hospital longer than did the OA patients (5.8 days instead of 5.4 days) and required more blood transfusions, in the end researchers found no differences in the overall rates of procedure-related, minor and major complications between the two groups.

Despite that encouraging news, Figgie advises that doctors carefully screen their RA patients. Though the bilateral procedure appears to be safe for RA patients who do not have significant heart disease, he notes that, “These are typically more challenging cases, and surgeons will want to coordinate patient care with rheumatologists to avoid flares during the postoperative period.”