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Joint Replacement Surgery Complications More Common In RA Patients

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The risk of complications in patients who have undergone hip or knee replacement surgery are still low and outcomes are generally good.

However, new research has found that some complications are more common in patients with rheumatoid arthritis (RA) who had their knee or hip replaced, compared with patients with osteoarthritis (OA).

The paper, which appeared in last month’s issue of Arthritis & Rheumatism, analysed data from 40 studies on joint replacement surgery published in 1990-2011, with information about outcomes in RA and OA patients who had undergone the procedures.

The new study examined five complications: infection, dislocation of new hip joints, early revision, blood clots and death.

Researchers found that the risk of infection after knee replacement was higher in RA patients, but surprisingly RA patients were also found to be more exposed to the risk of hip dislocation following hip replacement relative to patients with OA, says study co-author Dr Bheeshma Ravi of the Division of Orthopaedic Surgery at the University of Toronto.

According to Dr Ravi, the higher risk of hip dislocation for RA patients was an unexpected finding and one that requires further investigation, related to the use of certain implants or changes to the post-surgery rehabilitation protocol, to reduce this risk.

Still, the study findings should not discourage RA patients requiring joint replacement surgery as the operation is successful in 98% of patients, regardless of whether they have RA or OA, said Dr Michael Bronson, head of joint replacement surgery at Mount Sinai Medical Center in New York.