Increased risk of revision for infection in rheumatoid arthritis patients with total hip replacements

Acta Orthopaedica
Johannes C SchramaBjørg-Tilde S Fevang

Abstract

Medical treatment of rheumatoid arthritis (RA) has changed dramatically over the last 15 years, including immune modulation. We investigated the risk of revision for infection after primary total hip replacement (THR) in patients with rheumatoid arthritis over a 16-year period, and compared it with that in THR patients with osteoarthritis (OA). We identified 13,384 THRs in RA patients and 377,287 THRs in OA patients from 1995 through 2010 in a dataset from the Nordic Arthroplasty Register Association (NARA). Kaplan-Meier survival curves, with revision for infection as the endpoint, were constructed. Cox regression analyses were performed to calculate the relative risk (RR) of revision for infection adjusted for age, sex, fixation technique, and year of primary surgery. RA patients had a 1.3 times (95% CI 1.0-1.6) higher risk of revision for infection. After 2001, this risk increased more for RA patients than for OA patients. During the first 3 months and from 8 years postoperatively, the risk of revision for infection was higher in RA patients with THRs fixated with antibiotic-loaded cement than in corresponding OA patients. We found a slightly higher overall risk of revision for infection in RA patients than in OA patients, bu...Continue Reading

References

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Citations

Feb 3, 2016·International Orthopaedics·Brian E SchwartzMark H Gonzalez
Mar 17, 2017·Clinical Orthopaedics and Related Research·Gro S DyrhovdenOve Furnes
Dec 23, 2016·Current Molecular Biology Reports·Hilal Maradit KremersDavid G Lewallen
Jul 18, 2019·EFORT Open Reviews·Keijo T MäkeläSøren Overgaard
Feb 20, 2021·Hip International : the Journal of Clinical and Experimental Research on Hip Pathology and Therapy·Laura L MillerAlexander J MacGregor
Aug 3, 2020·The Journal of Rheumatology·Jasvinder A Singh, John D Cleveland

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