Overall benefits provided by orthopedic surgical intervention in patients with rheumatoid arthritis. Issue 2 (4th March 2019) - Ishikawa, Hajime
Abstract: Objectives: To clarify systemic effects of orthopedic surgical intervention in patients with rheumatoid arthritis (RA). Methods: A prospective observational cohort study was performed in RA patients who were scheduled to have primary elective orthopedic surgeries. Assessments were performed at baseline, 6 and 12 months after surgery using J-HAQ, General Health, EQ-5D, BDI-II, DAS28-CRP(4) and CRP for all registered patients, DASH and grip power for patients with upper-extremity surgeries, TUG for patients with lower-extremity surgeries, and JSSF for patients with ankle and forefoot surgeries. Results: There were 294 sites in 276 patients whose average age was 64 (19–89) years and average disease duration was 16 (1–60) years. Surgical site was shoulder in six patients, elbow in 26, wrist in 74, hand in 63, hip in 13, knee in 50, ankle in 12, and forefoot in 50. In total, physical function (J-HAQ, grip power, DASH, TUG, JSSF), quality of life (J-HAQ, General Health, EQ-5D) and depression (BDI-II) improved and disease activity (CRP, DAS28-CRP(4)) decreased significantly 6 and 12 months after surgery ( p <.01), despite some differences in their outcomes by the preoperative disease activity and the surgical site. Conclusion: Overall benefits were provided by orthopedic surgical intervention generally in patients with RA.