UNMC study: knee replacement viable option for rheumatoid arthritis

Kaleb Michaud, Ph.D., has for a long time listened to patients with rheumatoid arthritis (RA) talking about improved quality of life after their total joint replacements. But until now, there's been little information that actually measures how the surgery impacts quality of life for RA patients.

Much more information is known about the outcomes in osteoarthritis (OA) patients with the same surgery, even though RA is the most common inflammatory arthritis indicated for surgery.

Using the largest arthritis patient-report study in the U.S. - the National Data Bank for Rheumatic Diseases - Dr. Michaud and his collaborators expanded the number of measurements collected from patients and studied responses of 834 RA patients and 315 OA patients who had their first total knee replacement surgery between 1999 and 2012.

"Typically when patients have this surgery, only one or two measures are taken so it's hard to know how well it works for them," said Dr. Michaud, associate professor in the UNMC Division of Rheumatology and Immunology and senior author of the July 20 study featured in Arthritis & Rheumatology. "But we recorded a lot of measures taken over a longer period of time."

He said while the numbers aren't huge, researchers now have a lot more data on patient-recorded outcomes and quality of life than any other previous source.

"There are many studies that show the problems and complications after surgery in patients with RA, yet we showed there was a powerful and positive impact, on average, for them in our study," Dr. Michaud said.

Dr. Michaud said based on analysis, total knee replacement can improve the quality of life in RA patients, however, ultimately the arthritis usually returns.

"A new knee can give OA patients 10-20 years of painless use whereas RA continues affecting the joint soon afterward," he said. "It's an important and effective treatment, but patients with RA shouldn't expect the same, often dramatic results experienced by their OA counterparts. You've gotten rid of a knee plagued by arthritis, not the arthritis itself. Still, it's an important option that can dramatically improve the patient's quality of life."

RA is a form of arthritis that causes pain, swelling, stiffness and loss of function in joints.