Orthopaedic Surgery Trend in Rheumatoid Arthritis – results of the National Registry of Hospitalised Patients (CMBD) over a 17 year period (1999-2015). TREND-AR Study.
Abstract
Objective Analyse the trend of orthopaedic surgery (OS) rates on patients with rheumatoid arthritis.
Methods Retrospective observational study based on information provided by the Spanish National System of Hospital Data Surveillance. All hospitalisations of patients with RA for Orthopedicic Surgery (total hip arthroplasty -THA-, total knee arthroplasty -TKA-, arthrodesis and upper limb arthroplasty -ULA-) during the period 1999-2015 were analysed. The age-adjusted rate was calculated. Generalised linear models were used for trend analysis.
Results There were 21,088 OS in patients over 20 with (77.9% women). OS rate adjusted by age was 754.63/100,000 RA-patients*year (women 707.4; men 861.1). Neither an increasing nor decreasing trend noted for the global OS included. However, we noted trend and age interacted, so in the age ranges 20-40 and 40-60 years an annual reduction of 2.69% and 2.97%, respectively was noted. Whereas in the age ranges over 80 and 60-80 years we noted an annual increase of 5.40% and 1.09%, respectively. The average age at time of OS increased 5.5 years during the period analysed. For specific surgeries, a global annual reduction was noted in rates for arthrodesis. In THA, there was an annual reduction in patients under 80 years. In TKA and ULA, there was an annual reduction in patients under 60.
Conclusion Although the overall OS rate has not changed, there is a decrease in the rate of arthrodesis at all ages, THA in patients under 80 years of age, as well as TKA and ULA in patients under 60 years of age.