Trends in joint replacement surgery in patients with rheumatoid arthritis

Rheumatoid arthritis (RA) affects 1.3 million people in the United States. Till now, no study has been reported the prevalence of RA among patients undergoing total shoulder (TSA), elbow (TEA), knee (TKA), hip (THA), and ankle (TAA). Therefore, the present study state that the prevalence of RA has decreased among TSA and TEA patients. A nonsignificant decline occurred among TAA patients.

To examine trends in large total joint arthroplasties (TJA) and in the proportion of these methods implemented on individuals with rheumatoid arthritis (RA).

The identification of the total elbow (TEA), shoulder (TSA), hip (THA), knee (TKA), and ankle (TAA) arthroplasty incidences and the proportion of these accomplished with coexisting RA were done using the US Nationwide Inpatient Sample (2002–2012). 

The participants with TJA, TSA and TEA showed a 3.0% increased prevalence of RA. Patients with TSA, TAA and TEA showed an 18%, 38.0% and 50% decrease in RA prevalence, respectively and a nonsignificant rises were in TKA and THA. The mean age difference between RA and non-RA individuals going through TJA decreased by two years. Among the RA patients, women showed a greater decline in the proportion of TAA, TSA, and TEA groups as compared to the men.  The percentage of whites with RA were reduced in TEA and TSA. The proportion of TAA and TSA patients with RA who insured privately were reduced, whereas patients with RA going through TAA, TSA, and TEA who were getting Medicaid (government medical insurance) persisted almost stable over time.

The TEA and TSA patients showed a reduced RA prevalence. The TAA patients exhibited a nonsignificant drop. All TEA, TAA and TSA showed a similar pattern of sex ratios. These outcomes may be proof of the success of current RA management approaches.