The effect of drug treatment on functional outcomes of hip and knee joint replacement in patients with rheumatoid arthritis

Abstract

Aim – to determine the effect of drug antirheumatic therapy on the functional outcomes of hip and knee arthroplasty in patients with rheumatoid arthritis. Materials and methods. The results of 160 operations of total hip arthroplasty and 148 operations of total arthroplasty of knee joints in patients with rheumatoid joint lesions were analyzed using mathematical methods of statistical processing. Patients were divided into 4 groups: Group I – without anti-inflammatory therapy, Group II – received hormone therapy, Group III – basic therapy and Group IV – received both the basic and hormonal therapy at the time of surgery. Results. The obtained results indicated a moderate correlation between therapy and the joint range of motion of the lower extremities using basic therapy and combined nonsteroidal, hormonal and basic therapy, and the range of motion differed significantly in combination therapy from hormonal alone. The highest scores of the J. Joseph, E. E. Kaufman rating scale were observed in combination therapy with NSAIDs, hormonal and basic therapy; the lower scores – in hormonal and NSAIDs combination; and the lowest ones – in the combination of basic therapy with NSAIDs. The greatest increase in the knee joint range of motion was observed in the patients who received hormonal drugs or basic therapy compared to the patients who did not take any one or received both of these medicines in combination. Almost the same effect of antirheumatic therapy on the results of both hip and knee arthroplasty was determined with an upward trend in percentage of good and excellent results in males regardless of the lesion location and the most optimal ratio between satisfactory-unsatisfactory and good-excellent results in the patients under 40 years of age. Conclusions. The studies conducted allow to consider the combined drug therapy as a factor of weak and moderate influence on the functional outcomes of hip and knee arthroplasty in the late stages of rheumatoid arthritis and suggest that antirheumatic drug therapy should not be discontinued in the perioperative period.