The need for joint replacement in rheumatoid arthritis patients has waned since the advent of more effective treatments in the mid-2000s, but as a group, those who undergo this surgery remain at high risk for multiple adverse complications. A Danish register-based study recently teased out a key problem to watch for – non-surgical site infections such as sepsis and pneumonia.
The researchers obtained data from thousands of RA and osteoarthritis patients to investigate the risk of non-surgical infection, venous thromboembolism (VTE), heart attack and stroke after knee and hip replacement surgery. They also assessed the risk of complications among patients taking biologics vs. non-biologics to treat their condition.
Patients were followed for up to 90 days post surgery. Compared with OA patients, those with RA had a significantly higher risk of non-surgical site infections, but after knee replacement they had a lower risk of VTE (in which blood clots develop and travel to the lungs), wrote lead author René Cordtz, M.D. The study team also noted a “slightly increased” risk for VTE in RA patients who took biologics.
RA patients had no increased risk of post-surgical heart attack and stroke when compared with OA patients.
The study was published this month in Seminars in Arthritis and Rheumatism.
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