Features of a patient with rheumatoid arthritis with knee arthroplasty
Abstract
In order to identify the features of knee arthroplasty in patients with rheumatoid arthritis there has been conducted the study of postoperative period after knee arthroplasty in the groups with idiopatic osteoarthritis (group 1, n=1985) and secondary osteoarthritis on the background of rheumatoid arthritis (group 2, n=275). It was found that the postoperative hospital stay in Group 1 amounted to 14 days, the second - 20 days, post-operative blood loss by drainage in patients amounted to 370±120 mL and 640±180 mL (p <0,01), respectively. The sutures were removed in the patients of Group 1 at 14,0±2,1, the second group - by 19,0±3,1 days (p <0,01). In the patients of the 1st group blood transfusion was carried out in 5% of cases, in the second - in 15% of cases (p <0,01), marginal necrosis of wound edges was shown in 2% and 10% of cases (p<0,01), respectively, deep implant region infection was revealed in 1% and 6% (p <0,01), respectively. Powerful conservative therapy before arthroplastic surgery requires strict adjustment to reduce immunosuppressive action of drugs. This article presents an approach to the orthopedic surgical treatment of these patients.
References
2. Canadian Rheumatology Association Recommendations for the Pharmacological Management of Rheumatoid Arthritis with Traditional and Biologic Disease-modifying Antirheumatic Drugs: Part II Safety // The Journal of Rheumatology. - 2012. - Vol. 39. №8. - P.1583-1602.
3. da Silva E., Doran M.F., Crowson C.S., et al. Declining use of orthopedic surgery in patients with rheumatoid arthritis? Results of a long-term, population-based assessment // Arthritis Rheum. - 2003. - Vol. 49. - P216-220.
4. Kristensen O., Nafei A., Kjaersgaard-Andersen P., et al. Long¬term results of total condylar knee arthroplasty in rheumatoid arthritis // J. Bone Joint Surg. Br. - 1992. - Vol. 74. - P.803-806.
5. Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative // Ann Rheum Dis. - 2009. - Vol. 68. №7. - P1086-1093.
6. Tumour necrosis factor {alpha} antagonists and early postoperative complications in patients with inflammatory joint disease undergoing elective orthopaedic surgery // Ann Rheum Dis. - 2005. - Vol. 64. №4. - P650-651.
REFERENCES
1. Savenkova N.A., Amirdzhanova V.N., Makarov S.A., et al. Should disease-modifying therapy be stopped in patients with rheumatoid arthritis before endoprosthetic joint replacement? // Nauchno-prakticheskaya revmatologiya = Reumatology Science and Practice. - 2011. - №5. - P46-50. (in Russian)
2. Canadian Rheumatology Association Recommendations for the Pharmacological Management of Rheumatoid Arthritis with Traditional and Biologic Disease-modifying Antirheumatic Drugs: Part II Safety // The Journal of Rheumatology. - 2012. - Vol. 39. №8. - P.1583-1602.
3. da Silva E., Doran M.F., Crowson C.S., et al. Declining use of orthopedic surgery in patients with rheumatoid arthritis? Results of a long-term, population-based assessment // Arthritis Rheum. - 2003. - Vol. 49. - P216-220.
4. Kristensen O., Nafei A., Kjaersgaard-Andersen P, et al. Long¬term results of total condylar knee arthroplasty in rheumatoid arthritis // J. Bone Joint Surg. Br. - 1992. - Vol. 74. - P.803-806.
5. Multinational evidence-based recommendations for the use of methotrexate in rheumatic disorders with a focus on rheumatoid arthritis: integrating systematic literature research and expert opinion of a broad international panel of rheumatologists in the 3E Initiative // Ann Rheum Dis. - 2009. - Vol. 68. №7. - P1086-1093.
6. Tumour necrosis factor {alpha} antagonists and early postoperative complications in patients with inflammatory joint disease undergoing elective orthopaedic surgery // Ann Rheum Dis. - 2005. - Vol. 64. №4. - P650-651.
