Better Therapy Yields Decreased Joint Surgery in RA Patients

More effective management of rheumatoid arthritis (RA) with medication may be contributing to a decline in the need for joint surgery in patients with the condition, Mayo Clinic researchers have found.

The researchers used data from the Rochester Epidemiology Project and reviewed the medical records of all orthopedic surgeries following diagnosis of adult-onset RA in Olmsted County, Minn., from 1980 to 2007. They found 813 patients in all, who underwent surgeries including primary total joint arthroplasty, joint reconstructive procedures (JRP), soft tissue procedures (STP), and revision arthroplasty.

The researchers compared patients who were diagnosed from 1980 to 1994 with those diagnosed from 1995 to 2007 and found that the earlier cohort was more likely to receive joint surgery (27.3%) than the later cohort (19.5%) in the first 10 years following diagnosis. A particularly sharp reduction was observed in soft tissue procedures, which dropped from 12.1% in the earlier cohort to 6.0% in the later cohort. The researchers also found that, overall, females underwent more surgery (26.6%) than males (20.4%) and that surgeries tended to be performed on knees rather than hips.

"The findings of this study are encouraging for patients and their families," co-author Eric Matteson, MD, chair of rheumatology at the Mayo Clinic in Rochester, Minn., said in a press release. "The improvement in the disease course, with less joint damage and need for surgery in recent decades reflects the positive impact of modern therapy for rheumatoid arthritis, and highlights the importance of active disease management."

The study was published online Jan. 15 in The Journal of Rheumatology.