Rheumatoid arthritis can damage joints to such as extent that some people have to undergo joint replacement. A number of new medications like Tumor Necrosis Factor (TNF) inhibitors have been available during the recent years that prevent joint destruction and help to avoid surgery.
Studies indicate that in recent times, the need for total hip or knee replacement has come down to a large extent in patients with rheumatoid arthritis, probably due to the available medical treatment.
AdvertisementDr. Korosh Hekmat from Skane University Hospital, Sweden and colleagues investigated the trends in the incidence of total hip and knee arthroplasties in a well defined sample of patients with rheumatoid arthritis (RA).
For the study, subjects with rheumatoid arthritis, registered between 1997 and 2007 were included. Patients were classified according to the 1987 ACR criteria for rheumatoid arthritis. Patients who were registered with a total hip or knee arthroplasty before 1997 or before the diagnosis of rheumatoid arthritis were excluded. The incidence of registered total hip and knee arthroplasties were compared between the time period 1998 - 2001 when TNF inhibitors were introduced with the period between 2002 - 2006 (for total hip arthroplasties) / 2007 (for total knee arthroplasties) when biologics were established for the treatment of severe rheumatoid arthritis.
Study reports indicated that in the cohort (n=2164; 71% women) a primary hip arthroplasty was registered for 115 subjects and a primary knee arthroplasty for 82 subjects during the total study period. The incidence of total hip arthroplasties significantly decreased from the period of 1998-2001 to 2002-2006. However, the total knee arthroplasties increased slightly during this period.
The authors concluded the study by reporting, "The investigation shows a significant decrease in the incidence of total hip arthroplasties in patients with rheumatoid arthritis after 2001. The possible explanations to this include a positive effect on joint damage from a more aggressive pharmacological treatment."