Background Surgical treatment of patients with rheumatic diseases (RD) is associated with increased risk of complications. It is caused presence of an inflammatory process, osteoporosis, the reduced physical activity, the severity of functional impairment, long-term glucocorticoid therapy, biologic and disease-modifying antirheumatic drugs. All this contributes to increase the risk of perioperative complications, including periprosthetic fractures.
Objectives To compare freguency of periprosthetic fractures of hip and knee replacement in patients with rheumatic diseases (RD).
Methods In 1475 patients with RD in the period from 1998 to 2013 were execute in 2038 hip replacement surgery (n=1195) and knee replacement surgery (n=843) (osteoarthritis (OA) – 799, rheumatoid arthritis (RA) – 913, juvenile rheumatoid arthritis (JRA) – 206, systemic lupus erythematosus (SLE) – 120).
Results Total identified 63 (3.09%) periprosthetic fractures in patients with RD.
In this periprosthetic fractures in hip replacement were 54 (4.52%): 19 (4.9%) in RA patients, 13 (8.9%) patients with JRA, 6 (6.38%) in patients with SLE and 15 (2.64%) in patients with OA (3.16%).
Periprosthetic fractures after knee arthroplasty were 10 (1.19%): 6 (1.14%) in patients with RA, 3 (5%) patients with JRA, 0 SLE patients and 1 (0.43%) in patients with OA (0.46%).
Also from 64 patients with periprosthetic fractures complications in 5 patients (3 patients with OA, 1 with RA and 1 with JRA) after total hip arthroplasty was made 8 revisions of joint endoprostheses.
We revealed a significantly greater number of complications in patients with JRA (p<0.005).
Conclusions The results confirm that the surgical treatment of patients with RD, especially RA, JRA, SLE, requires a specific approach, which consists in a competent medication administered to the patient with rheumatologist and careful treatment of the bone and surrounding tissues during surgery.
Disclosure of Interest None declared