PT  - JOURNAL ARTICLE
AU  - Susan M.  Goodman
AU  - Beverly Johnson
AU  - Meng Zhang
AU  - Wei-Ti Huang
AU  - Rebecca Zhu
AU  - Mark Figgie
AU  - Michael Alexiades
AU  - Lisa A.  Mandl
TI  - Patients with Rheumatoid Arthritis have Similar Excellent Outcomes after Total Knee Replacement Compared with Patients with Osteoarthritis
AID  - 10.3899/jrheum.150525
DP  - 2015 Dec 01
TA  - The Journal of Rheumatology
PG  - jrheum.150525
4099  - http://www.jrheum.org/content/early/2015/11/25/jrheum.150525.short
4100  - http://www.jrheum.org/content/early/2015/11/25/jrheum.150525.full
AB  - Objective Although new treatments for rheumatoid arthritis (RA) are extremely effective in preventing disease progression, rates of total knee replacement (TKR) continue to rise. The ongoing need for TKR is problematic, especially as functional outcomes in patients with RA have been reported to be worse than in patients with osteoarthritis (OA). The purpose of this study is to assess pain, function, and quality of life 2 years after TKR in contemporary patients with RA compared with patients with OA. Methods Primary TKR cases enrolled between May 1, 2007 and July 1, 2010 in a single institution TKR registry were eligible for this study. Validated RA cases were compared with OA at baseline and at 2 years. Results We identified 4456 eligible TKR, including 136 RA. Compared with OA, RA TKR had significantly worse preoperative Western Ontario and McMaster Universities Osteoarthritis Index pain (55.9 vs 46.6, p < 0.0001) and function (58.7 vs 47.3, p < 0.0001); however, there were no differences at 2 years. Within RA, there was no difference for patients who were treated with biologic disease-modifying antirheumatic drugs versus those who did not in pain (p = 0.41) or function (p = 0.39) at 2 years. In a multivariate regression, controlling for multiple potential confounders, there was no independent association of RA with 2-year pain (p = 0.18) or function (p = 0.71). Satisfaction was high for both RA and OA. Conclusion Patients with RA undergoing primary TKR have excellent 2-year outcomes, comparable with OA, in spite of worse preoperative pain and function. In this contemporary cohort, RA is not an independent risk factor for poor outcomes.