Background:Surgical treatment of patients with rheumatoid arthritis (RA) is associated with an increased risk of complications. This is due to the presence of inflammation, many variants of the disease, reduced physical activity, severity of functional disorders, prolonged therapy with glucocorticoids, disease-modifying antirheumatic drugs (DMARDs) and biological DMARDs, osteoporosis, as well as activity of the underlying disease.Objectives:to conduct a comparative analysis of the influence of RA activity levels on infectious complications (periprosthetic infection) and wound complications (poor healing, divergence, necrosis of the wound edges) after hip and knee arthroplasty in RA patients.Methods:1113 arthroplasties were analyzed in patients with RA, which were performed between 2002 and 2019. Of these, 649 total knee arthroplasties and 464 total hip arthroplasties were performed.Results:Infectious complications after total hip and knee arthroplasty did not occur at 0 grade of disease activity (remission). At the I grade of activity, periprosthetic infections were detected with a frequency of 0.31%, at the II grade – 0.89%, and at the III level in 3.06% of cases.Complications from the operative wound occurred in 0.91% of cases with I grade of activity, at II grade with a frequency of 5.68%, and at III – 6.98%. There were no cases of complications from the wound in patients with remission of RA.Statistical analysis of the obtained data revealed a significantly higher number of complications in the group of RA patients (p<0.005). During analyzing each type of complication, significant differences were also obtained (p<0.005).Conclusion:Risk of periprosthetic infection and complications from the wound is several times higher in patients with a high grade of RA activity. This means that performing arthroplasty, as well as other operations, in patients with high RA activity correlates to a high risk of complications.Disclosure of Interests:None declared
Risk of revision for infection in primary total hip and knee arthroplasty in patients with rheumatoid arthritis compared with osteoarthritis: A prospective, population-based study on 108,786 hip and knee joint arthroplasties from the Norwegian Arthroplasty Register