Complications More Likely in RA Patients After Joint Arthroplasty

Hip dislocations and infections are more likely to develop in rheumatoid arthritis (RA) patients who undergo hip or knee replacement surgery than in osteoarthritis (OA) patients after the same procedures.

Specifically, RA patients who had hip arthroplasty had more than twice the risk of hip dislocation compared to OA patients: 2.16 (95% CI 1.52 to 3.07), and nearly twice the risk of infections after knee replacement: 1.86 (95% CI 1.31 to 2.63).

The conclusion comes from a meta-analysis by a team of doctors at the University of Toronto, headed by Dr. Basheema Ravi. They analyzed 40 studies published between 1990 and 2011, which allowed them to consider an average of 200 joints of RA and OA patients after hip or knee arthroplasty. While the reviewers looked at several issues, including 90-day mortality and venous thromoboembolic events, hip dislocation and infections were the two complications they saw developing most often.

A key challenge in drawing conclusions, the reviewers admit, is that the studies included far more OA patients than RA patients.