Total knee arthroplasty on the disease activity of rheumatoid arthritis

Abstract

The effects of total knee arthroplasty (TKA) on the disease activity of rheumatoid arthritis (RA) was investigated in the present study. The disease activity of RA in 58 patients who had undergone simultaneous bilateral TKA (116 knee joints) was examined before, and 1, 6 and 12 months and 3 and 5 years after the operation. The disease activity was assessed using the simplified Lansbury index according to the duration of morning stiffness, grip strength, joint count and erythrocyte sedimentation rate. In addition, C-reactive protein (CRP) and rheumatoid factor were also measured. The mean simplified Lansbury index and CRP significantly improved 1, 6 and 12 months after TKA surgery compared to preoperative levels. However, 3 and 5 years after TKA, the mean simplified Lansbury index indicated that the disease activity remained lower than the preoperative level in only 21 (36%) patients. The results of the present study demonstrate that TKA lowers RA activity for at least 1 year after surgery, and thus synovectomy and surgical resection of articular cartilage in the knee joint appear to have an anti-rheumatoid effect.