Total Knee Arthroplasty Like a “Time Machine” for Rheumatoid Arthritis Patients

December 16, 2015
Rachel Lutz

Researchers examined data from 19,000 rheumatologist-diagnosed rheumatoid arthritis and osteoarthritis patients in order to assess and compare the impact of total knee arthroplasty on pain and health-related quality of life.

Knee surgery is highly effective in reducing knee pain in patients with rheumatoid arthritis (RA), according to findings published in Arthritis & Rheumatology.

Researchers from centers in Kansas examined almost 19,000 rheumatologist-diagnosed RA and osteoarthritis (OA) patients in order to assess and compare the impact of total knee arthroplasty (TKA) in these patients. The patients were undergoing primary TKA during 1999 to 2002. The researchers collected data from the patients about indices of pain (including overall, index knee, and contralateral knee) and health-related quality of life across three six-month intervals (baseline, at preoperative times; perioperative; and postoperative recovery).

Of the total patients, 834 of those with RA (5.3 percent) and 315 of those with OA (10.2 percent) underwent index TKA at similar mean ages, about 65 and 68 years. The researchers discovered improvements in the areas of pain, function, and health related quality of life within both RA and OA disease groups — even greater impact was noted in the OA patient group.

The researchers added that RA diagnosis, lower income, or perioperative anxiety were independently associated with a lower degree of improvement in index knee pain following TKA. The authors said TKA may be able to serve as a “time machine,” from which patients can reset back to a less disabled lifestyle before the arthritic effects return for RA patients.

“A new knee can give osteoarthritis patients 10 to 20 years of painless use, whereas RA continues to affect the joint soon afterward,” the study’s senior author Kaleb Michaud, MD, explained in a press release. “It’s an important and effective treatment, but patients with RA shouldn’t expect the same, often dramatic results experienced by their osteoarthritis counterparts. You’ve gotten rid of a knee plagued by arthritis, not the arthritis itself. Still, it’s an important option that can dramatically improve the patient’s quality of life.”