Objectives To identify complications after total joint arthroplasty in rheumatoid arthritis (RA) patients (pts) treated with biologic and nonbiologic disease-modifying antirheumatic drugs (DMARDs).
Methods In a retrospective 1:1 pair-matched case–control study 60 pts with RA after total hip arthroplasty (THA) and total knee arthroplasty (TKA), matched in type of surgery and gender, were evaluated for surgical site infection (SSI) and deep venous thrombosis (DVT) in the postoperative period. Pts with RA were split into a biologic group (n=30) treated with biological agents (16 pts - rituximab, 8- infliximab, 3- abatacept and 3- tocilizumab), and a nonbiologic group (n=30) treated only with conventional disease-modifying antirheumatic drugs (21 pts – methotrexate and 4- leflunomide). Nonbiologic DMARDs were continued perioperatively, biologic treatment was stopped and restarted in accordance with Russian guidelines. Baseline characteristics were compared using the Mann-Whitney U-test or Fisher’s exact test.
Results Table 1 shows the baseline characteristics of the pts. For the period from 2 till 12 months after surgery 2 pts (3,3%) had DVT, one pt (1,65%) in biologic group and one (1,65%) in nonbiologic group. Only in nonbiologic group we identified 2 cases (3,3%) with postoperative complications of superficial infections requiring the use of antibiotics. Deep infection was found in only 1 case (1,65%) in biologic group, which was treated with infliximab and necessitated surgical treatment by removal of the artificial joint prosthesis.
Conclusions In RA patients receiving biologic DMARDs, infections after total joint arthroplasty was rare but potentially more severe. Thus prospective studies are needed to determine the safety of biologic treatment in the perioperative period.
Disclosure of Interest None Declared