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A study published in the European League Against Rheumatism Annual Congress last month shows that the incidence of knee and hip replacement declined after the introduction of biologics to national rheumatoid arthritis (RA) treatment guidelines.
The study looked at 30,868 patients diagnosed with RA at the rheumatology department between 1996 and 2011 and compared them with 301,527 controls from the general population. The baseline total knee replacement (TKR) incidence rate per 1,000 person-years was 5.87 for RA versus 0.42 for the controlled group. Prior to 2002, the incidence of total knee replacement increased among RA patients, but started to decrease after the introduction of bDMARDs and their associated guidelines in 2003. In February of 2007, the rate of TKR changed to 1.8 TKRs/1,000 person. Over the study period, the incidence of total knee replacement and total hip replacement increased among the general population controlled group. In contrast, there was a downward trend among RA patients.
Lene Dreyer, MD, from the Center for Rheumatology and Spine Diseases in Denmark, is one of the author the study. Dreyer explained: "Our findings show a clear downward trend in these two operations in RA patients in Denmark since the additions of [biologic disease-modifying anti rheumatic drugs] bDMARDs to treatment protocols. Also, the overall pattern of our findings is in line with those recently reported from England and Wales."
Below is a video examining the quality of rehabilitation care, specifically in hip and knee replacements: Continue reading
A clinical symposium yesterday at the ACR called New Frontiers in Osteoarthritis Treatment: The Role of Weight Loss, Surgery and Current Treatment Guidelines looked at the management of osteoarthritis (OA) patients through weight loss and exercise, surgery, and medications. The session also looked at the differences in treatment recommendations for OA.
Osteoarthritis and weight loss and exercise
In an interview with ACR Daily News, Stephen P. Messier, PhD, Professor of Health and Exercise Science at Wake Forest University, said: "When combined with exercise, weight loss is a level 1 method of treatment for knee osteoarthritis, and there's strong support for both weight loss and exercise as the first-line treatment for knee osteoarthritis. I think the problem is that patients don't know how to do it."
According to a government report in 2012, the rate of knee replacement surgeries has risen in the United States from 378,000 in 2003 to an estimated 704,000 in 2012 over the last decade. There is also a growing trend that people are doing these surgeries at a younger age.
The rise is in part due to the success rate of knee replacement surgeries. NBC Nightly News anchor Brian Williams talks about his injury and upcoming knee surgery. This news report is the first reportof a three-part series about knee replacement. We hope it will assist you in your decision on whether you want to proceed with a knee surgery. Remember to communicate with your healthcare team in your decision making process.
Below are some interesting stats on knee replacement surgeries.
People who live with arthritis, particularly those with inflammatory types and whose immune systems are suppressed, may be more susceptible to bacteria such as Clostridium difficile (C. difficile) while in hospital for surgery or a medical emergency related to their arthritis. Continue reading
Women and smaller men are being warned against "resurfacing", which is an alternative to traditional hip replacement procedures. The procedure, originally promoted as a method that would allow younger patients to stay more active, turns out to have an "unacceptably high" early failure rate compared to plastic-and-metal implants.
Read more: Barry Meier, The New York Time, October 2012
A recent study showed that smokers did not heal as well from knee surgery as non-smokers, and experienced more pain after.
Read more: Kerry Grens, Reuters, September 2012