Fewer Joint Surgeries With Recent RA Diagnosis


Better rheumatoid arthritis treatments may be reducing the need for potentially dangerous joint replacements, say Mayo Clinic researchers.

For patients who recently received a diagnosis of rheumatoid arthritis (RA), the rates of arthritis-related joint surgery continue to decrease, according to researchers in the departments of medicine and health sciences research at the Mayo Clinic College of Medicine. The investigators also found that joint reconstructive procedures (JRP) are associated with increased mortality.

Shourt and associates performed a retrospective medical record review of orthopedic surgeries after diagnosis in cases of adult-onset RA in 1980-2007. Surgeries included primary total joint arthroplasty, JRP, soft tissue procedures (STP), and revision arthroplasty.

The cumulative incidence of any joint surgery at 10 years after RA incidence for the 1980-1994 cohort was 27.3%, compared with 19.5% for the 1995-2007 cohort. The greatest reduction was in STP. Women had more surgery than men, and obese patients had more surgery than nonobese patients. Mortality was significantly higher in patients who required JRP than in those who did not require the procedures.

The findings may reflect improved treatments for patients with RA as well as a continued higher disease burden among some patients, the investigators noted. The study was published online in the Journal of Rheumatology.

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