Even though the beneficial impact of total knee arthroplasty (TKA) on outcome measures such as knee pain and function in patients with rheumatoid arthritis (RA) has been well documented, studies pertaining to its effect on health related quality of life (HRQoL) are scarce. Moreover, these studies are almost exclusively limited to osteoarthritis (OA) patients with very limited data regarding the effects of TKA in a context of RA. This represents a critical knowledge gap given the frequency with which TKA is performed in RA, a condition that could conceivably influence measures of pain, function, and HRQoL in response to a surgical intervention.
In a study published in the journal Arthritis & Rheumatology, titled “Impact of total knee arthroplasty using patient reported pain and health-related quality of life indices: Rheumatoid arthritis versus osteoarthritis”, researcher Kaleb Michaud from the Nebraska Arthritis Outcomes Research Center, University of Nebraska Medical Center,Omaha, and colleagues assessed and compared the impact of total knee arthroplasty (TKA) in patients with rheumatoid arthritis (RA) and osteoarthritis (OA). The team found that in a total of 18,897 patients (834 RA and 315 OA) who underwent TKA, surgery was highly effective to reduce knee pain while providing benefits in other subjective quality of life indices in RA patients. However, improvements were not as great as those experienced by osteoarthritis patients.
Based on their results researchers concluded that total knee replacement can serve as a “time machine” via which patients can return to a less disabled lifestyle, before the arthritic process catches up. “A new knee can give osteoarthritis patients 10 to 20 years of painless use, whereas rheumatoid arthritis continues to affect the joint soon afterward. It’s an important and effective treatment, but patients with rheumatoid arthritis shouldn’t expect the same, often-dramatic results experienced by their osteoarthritis counterparts,” said in a recent news release Dr. Kaleb Michaud, study’s senior author “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.”