Long-term outcomes and duration of outdoor ambulation following primary total knee arthroplasty in patients with rheumatoid arthritis

Yamashita, Fumiyoshi; Funakoshi, Noboru; Mori, Daisuke; Kizaki, Kazuha

doi:10.1016/j.jos.2021.01.014

Cited by 6 publications

(7 citation statements)

References 26 publications

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“…Yamashita et al, 23 in their study with average follow-up of 10.6 years post-TKA showed that the cumulative survival rates were 98.9%, 98.4%, and 96.6% at 5 years, 10 years and at 15 years respectively. Hayashi et al, 8 in their study on 45 patients undergoing major joint replacement noted that mean DAS28-ESR 1 year before surgery to baseline values before surgery were same (4.08 ± 0.89 and 4.32 ± 0.99, P = 0.1496) and the 1 year post-operative value showed significant reduction (3.35 ± 0.93, P = 0.0007)…”

Section: Resultsmentioning

confidence: 93%

“…Yamashita et al, 23 the rate of outdoor ambulation was 87.8% at 5 years, 72.8% at 10 years and 48.8% at 15 years and they showed that age of TKA (younger), body weight (higher), steroid use (higher) and usage of biologicals (lower) were significant factors that determine walking ability post-TKA. They concluded stating that decreasing steroid use and controlling RA activity using pharmacological therapy (cDMARDs/ bDMARDs) are important factors for preserving outdoor ambulation.…”

Section: Discussionmentioning

confidence: 98%

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Disease activity and flares after total knee arthroplasty in rheumatoid arthritis - Systematic review

Jayakumar

Nayak²

2023

IJOR

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Despite the continuous therapeutic development of biological DMARDs which has delayed disease progression in Rheumatoid arthritis, joint destruction is inevitable and end-stage arthritis remains the ultimate outcome, following which surgical intervention becomes a necessity. Controversy still exists about the systemic effects following Total Knee Arthroplasty (TKA) on patients in terms of disease activity and flares during the peri-operative period since most patients present with varying levels of disease activity at the time of surgery. The objective of this review is to determine the influence of TKA on longitudinal disease activity and flares in patients with rheumatoid arthritis and to determine its influence on quality of life, laboratory parameters, and medication requirement during the peri-operative period and subsequent long-term follow-ups. A complete search was conducted according to the PRISMA guidelines in Pubmed/MEDLINE, Scopus, Google Scholar, Web of Science electronic databases and trial registries on disease activity or flares in patients suffering from rheumatoid arthritis after total knee replacement in September 2022. A total of 16 studies were identified for final review. Flares (RA-FQ), DAS-28, CDAI, mHAQ, ESR, CRP and medication requirement were evaluated in serial follow-ups before and after TKA. Majority of the studies show confirm that a combination of TKA and pharmacological therapy can achieve better therapeutic effects and maintain disease activity at low/ remission levels in patients with end stage rheumatoid arthritis. Patients with high disease activity during the perioperative period are less compliant to rehabilitation and physiotherapy, thereby affecting their overall function scores and satisfaction with the procedure and are found to be more prone to flares. TKA is found to reduce overall disease activity in RA and reduce the need for medication requirement. However, patients with a high disease activity pre-operatively remain at risk for flares and are unable to reach remission levels of activity after TKA and require supplemental long term pharmacological therapy thereby highlighting the need for adequate pre-operative optimization.

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Section: Resultsmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 98%

Disease activity and flares after total knee arthroplasty in rheumatoid arthritis - Systematic review

Jayakumar

Nayak²

2023

IJOR

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“…Based on the selection criteria, we identified 24 articles for systematic review and a meta-analysis to assess differences in SSI and VTE rates, respectively. [1][2][3][4][5][9][10][11][12][13][14][15][16][17][19][20][21][22][23]26,[29][30][31][32][33][34] The selection process and list are shown in Figure 1. Extracted data and characteristics of the 20 studies that evaluated postoperative SSI are outlined in Table 1; in the same way, 6 studies describing VTE are listed in Table 2.…”

Section: Study Selection and Characteristicsmentioning

confidence: 99%

“…Borgas et al, [21] Retrospective cohort Ito et al, [22] Retrospective case control, Japan Yamashita et al, [23] Retrospective cohort, Japan *SSI using Centre for Disease Control (CDC) criteria [24] . †SSI using CDC criteria [25] .…”

Section: Ssi Unclearmentioning

confidence: 99%

The impact of bDMARDs on postoperative complications in patients with rheumatoid arthritis: A systematic review and meta-analysis

Suto,

Okamura,

Sakane

et al. 2023

Medicine

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Background: The influence of biological disease-modifying antirheumatic drugs (bDMARDs) on postoperative surgical site infection (SSI) and venous thromboembolism (VTE) in patients with rheumatoid arthritis (RA) has not yet been clarified. Methods: A systematic literature search was performed using PubMed, Web of ScienceTM, Scopus, and The Cochrane Library databases to identify eligible studies published up to August 2023. All studies comparing postoperative SSI or VTE rates in RA patients with or without bDMARD treatment were included. The protocol for this study was registered in PROSPERO (CRD42021246264) and is available on the University of York website. Results: Overall, 20 studies with 71,885 RA patients and 6 studies with 7918 RA patients were included for postoperative SSI and VTE comparisons, respectively. Patients treated with bDMARDs had significantly higher rates of postoperative SSI than those without treatment (odds ratio 1.50, 95% confidence interval 1.23–1.83, P < .0001). However, these significant differences disappeared in the analysis restricted to 9 studies involving non-tumor necrosis factor α inhibitors. The use of bDMARDs seemed to increase the rate of postoperative VTE (odds ratio 2.20, 95% confidence interval 1.30–3.72, P = .003). A subgroup analysis showed that postoperative osseous complications were significantly less frequent in RA patients with bDMARD treatment than in those without treatment. Conclusion: RA patients treated with bDMARDs had an increased risk of not only postoperative SSI but also VTE. While bDMARD usage merits appropriate attention, there might be positive aspects as well. Further data will be needed to confirm the postoperative risks of bDMARD usage in RA patients.

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“…DAIR is not recommended for late-onset hematogenous infection [2,3,7] . From 1997 to 2011, we performed 487 TKAs in patients with rheumatoid arthritis and osteoarthritis [8,9] . No patient developed the acute infection within one year after surgery.…”

Section: Introductionmentioning

confidence: 99%

A late-onset infection after total knee arthroplasty cured without the revision of the femoral and tibial components: A case report

Yamashita¹,

Mizuno²,

Ito³

et al. 2022

Int. J. Case Rep. Orthop.

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Prosthetic joint infection is a complication of total knee arthroplasty (TKA), which needs to eradicate the infection. M anagement of infected TKA includes debridement, antibiotics administration, implant retention (DAIR), one-or two-stage revision arthroplasty, arthrodesis, and amputation. Usually, DAIR or two-stage revision joint replacement surgery is needed. A case of a late-onset infection following TKA that was effectively treated with a two-stage surgery was described. The first operation included curettage of infected bone and cement and filling of the defect with antibiotic-containing cement in addition to soft tissue debridement. One month later, fresh antibiotic-containing cement was filled after the cement was removed, and a polyethylene insert was seated. The infection subsided without revision of the femoral and tibial components, and furthermore, the recurrence of the infection was eradicated in the long term. We recommend not only debridement of soft tissue but also curettage of infected bone and cement as an addition to the DAIR procedure.

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Long-term outcomes and duration of outdoor ambulation following primary total knee arthroplasty in patients with rheumatoid arthritis

Cited by 6 publications

References 26 publications

Disease activity and flares after total knee arthroplasty in rheumatoid arthritis - Systematic review

Disease activity and flares after total knee arthroplasty in rheumatoid arthritis - Systematic review

The impact of bDMARDs on postoperative complications in patients with rheumatoid arthritis: A systematic review and meta-analysis

A late-onset infection after total knee arthroplasty cured without the revision of the femoral and tibial components: A case report

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