Worse Outcomes for Total Joint Arthroplasty in RA Versus OA

Patients with rheumatoid arthritis have increased risk of dislocation after THA, infection after TKA

FRIDAY, Nov. 30 (HealthDay News) -- Patients with rheumatoid arthritis (RA) are at higher risk of dislocation and infection following total joint arthroplasty compared to patients with osteoarthritis (OA), according to a review published in the December issue of Arthritis & Rheumatism.

Bheeshma Ravi, M.D., from the University of Toronto, and colleagues conducted a literature review of studies involving primary total joint arthroplasty of the hip (THA) or knee (TKA) which included information on outcomes in at least 200 RA and OA joints. Meta-analysis was performed when appropriate, or the level of evidence was assessed qualitatively.

The researchers found that, based on 40 studies, patients with RA were at increased risk of dislocation following THA (adjusted odds ratio, 2.16). Following TKA, fair evidence indicated an increased risk of infection and early revision in RA versus OA. For patients with RA versus OA, at later time points there was no evidence of any differences in rates of revision, 90-day mortality, or rates of venous thromboembolic events following THA or TKA. Only three studies explicitly defined RA (7.5 percent), and adjustment for covariates was included in 11 of the studies (27.5 percent).

"Adequately powered studies, which incorporate validated definitions for RA and OA diagnosis and control for appropriate confounders and other covariates, are needed to confirm these findings," Ravi and colleagues conclude.

One author disclosed financial ties to the pharmaceutical industry.

Abstract
Full Text (subscription or payment may be required)

Copyright © 2012 HealthDay. All rights reserved.

Powered by

jQuery UI Accordion - Default functionality

For life-long learning and continuing professional development, come to Lippincott's NursingCenter.

Nursing Jobs Plus
Featured Jobs
Recommended CE Articles

Blunt Chest Trauma
Journal of Trauma Nursing, November/December 2014
Expires: 12/31/2016 CE:2 $21.95


The School Age Child with Congenital Heart Disease
MCN, The American Journal of Maternal/Child Nursing, January/February 2015
Expires: 2/28/2017 CE:2.5 $24.95


Understanding multiple myeloma
Nursing Made Incredibly Easy!, January/February 2015
Expires: 2/28/2017 CE:2 $21.95


More CE Articles

Subscribe to Recommended CE

Recommended Nursing Articles

Comprehensive Care: Looking Beyond the Presenting Problem
Journal of Christian Nursing, January/March 2015
Free access will expire on March 2, 2015.


Pain and Alzheimer dementia: A largely unrecognized problem
Nursing Made Incredibly Easy!, January/February 2015
Free access will expire on February 16, 2015.


Glycemic control in hospitalized patients
Nursing2015 Critical Care, January 2015
Free access will expire on February 16, 2015.


More Recommended Articles

Subscribe to Recommended Articles

Evidence Based Practice Skin Care Network NursingCenter Quick Links What’s Trending Events