Predictors of and outcomes following orthopaedic joint surgery in patients with early rheumatoid arthritis followed for 20 years

Rheumatology
James M GwinnuttSuzanne M M Verstappen

Abstract

To analyse predictors and outcomes of major orthopaedic surgery in a cohort of RA patients followed for 20 years. Patients were recruited to the Norfolk Arthritis Register from 1990 to 1994. Demographic and clinical variables (including the HAQ and swollen and tender joint counts) were assessed at baseline; the 2010 ACR/EULAR RA classification criteria were applied. Patients reported incident comorbidities and major orthopaedic joint surgery (replacement, synovectomy, fusion, excision) when reassessed at years 1, 2, 3, 5, 7, 10, 15 and 20. Baseline and time-varying predictors of orthopaedic surgery were assessed using a conditional risk set model, a type of multiple-failure survival analysis. Change in disability after surgery was assessed using weighted mixed-effects linear regression. Of 589 RA patients [median age 56 years (IQR 45-68); 66.7% women] recruited to the Norfolk Arthritis Register with at least one follow-up, 102 reported a total of 180 major surgeries, with hip replacement being the most common (n = 68/180). Patients reporting major surgery had worse functional disability at all time points, but similar swollen/tender joint counts to those without major surgery. Each unit increase in HAQ score was associated with...Continue Reading

References

Jan 1, 1996·The Journal of Arthroplasty·C A MancusoM E Charlson
Jun 10, 2004·Arthritis and Rheumatism·S M M VerstappenUNKNOWN Utrecht Rheumatoid Arthritis Cohort Study Group
Jul 5, 2005·Clinical Orthopaedics and Related Research·Wayne B LeadbetterMichael A Mont
May 9, 2006·Annals of the Rheumatic Diseases·S M M VerstappenJ W G Jacobs
Aug 7, 2008·American Journal of Epidemiology·Stephen R Cole, Miguel A Hernán
Jul 8, 2009·Annals of the Rheumatic Diseases·Grant H Louie, Michael M Ward
Sep 28, 2010·Lancet·David L ScottTom W J Huizinga
Feb 7, 2013·BMJ : British Medical Journal·Aroon D HingoraniUNKNOWN PROGRESS Group

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Citations

Jul 17, 2021·Current Pain and Headache Reports·Kristen MathiasAlaa Abd-Elsayed

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