Risk Factors Associated With Short-term Clinical Results After Total Hip Arthroplasty for Patients With Rheumatoid Arthritis.

Abstract

Clinical outcomes of total hip arthroplasty for rheumatoid arthritis are reportedly worse than those of total hip arthroplasty for osteoarthritis of the hip. The authors examined pre- and postoperative factors associated with the modified Harris hip score (mHHS). Fifty-one joints of 48 rheumatoid arthritis patients who underwent total hip arthroplasty were studied retrospectively. The authors examined the correlation between preoperative rheumatoid arthritis disease activity (Disease Activity Score in 28 joints-C-reactive protein and C-reactive protein) and mHHS at 1 year after total hip arthroplasty. Furthermore, pre- and postoperative mHHS values were compared between patients with other affected joints and patients with no affected joints in the lower limbs. The mean mHHS improved to 73.5 points postoperatively from 36.4 points preoperatively. Preoperative Disease Activity Score in 28 joints-C-reactive protein and C-reactive protein values were negatively correlated with pre- and postoperative mHHS values. Preoperative mHHS was not significantly different between the affected and not affected groups; however, postoperative mHHS was significantly lower in the affected group than in the not affected group. Total hip arthroplasty showed good clinical results for rheumatoid arthritis at short-term follow-up. However, pre- and postoperative mHHS values were influenced by preoperative rheumatoid arthritis disease activity. Moreover, the presence of additional affected joints in the lower limbs preoperatively resulted in a lower postoperative mHHS. Unlike patients with osteoarthritis, patients with rheumatoid arthritis often have multiple affected joints, which may contribute to a lower mHHS. Comprehensive treatment, including surgery for the other affected joints in the lower limbs, may improve a patient's postoperative mHHS. [Orthopedics. 2018; 41(6):e772-e776.].