Do Aggressive Course of the Disease Predicts Total Joint Replacement Surgery in Patients with Rheumatoid Arthritis?

Evija Stumbra Stumberga^1*, Gaida Krumina², Silva Senkane³, Olga Voika⁴, Liana Ziedina⁵ & Edgars Vasilevskis⁶

¹Specialist in Rheumatology, Department of Rheumatology, Riga Stradins University, Latvia
²Professor of Radiology, Department of Radiology, Riga Stradins University, Latvia
³PhD specialist in Quantitative Social Research, Statistics Unit, Riga Stradins University, Latvia
⁴Specialist in Radiology, Lecturer in Language Centre, Riga Stradins University, Latvia
⁵Specialist in Neurosonology, Health Center 4, Latvia
⁶PhD Specialist in Anesthesiology, Riga Stradins University, Institute of Anatomy and Antropology, Latvia

Dr. Evija Stumbra Stumberga, Department of Rheumatology, Riga Stradins University, Latvia.

Keywords: Rheumatoid Arthritis; Total Joint Replacement Surgery; Disease Activity

Abstract

Rheumatoid arthritis is a chronic systemic autoimmune disease. It causes chronic inflammation of joints manifesting with swelling, pain, synovitis and joint destruction. High work disability rates, as well as functional decline due to knee and hip joint destruction can lead eventually to both total knee and hip replacement surgeries. Little is known about the predictors of the prevalence of joint arthroplasty over the course of the disease. Therefore, verification of the predictive factors of aggressive disease course could manage the need for joint arthroplasty in future. The purpose of our study was to analyse and evaluate the factors contributing to the need of joint replacement surgery with regard to the highly aggressive course of the disease in a cohort of rheumatoid arthritis (RA) patients. A case-control prospective study was conducted with one hundred fifteen RA patients. According to our case-control study, both high disease activity evaluated as Das 28>5.1 and high titers of Anti-CCP (above 500 U/ml) were not strong predicting factors of joint replacement therapy. Neither the age when RA was diagnosed, nor the age when complaints started, seropositivity for Anti-CCP, RF, synovitis in the small joints, comorbidities (primary arterial hypertension, stroke, diabetes mellitus), smoking history, and BMI had any association with the joint replacement surgery. However, we determined that only those patients with erosive changes in the small joints of the hands and feet (detected radiographically) required a total joint arthroplasty.

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