Background Endoprosthesis is an effective method of pain relief and can improve knee function in patients with rheumatoid arthritis (RA). There remains the question of RA drug therapy in the perioperative period
Objectives To review the results of knee arthroplasty depending on the initial activity of the disease.
Methods Knee replacement was done 54 RA patients (48 women, 6 men), mean age 49, 8±16,14 years. At the time of the operation duration of the disease was 12,79±6,18 years, high activity (DAS28) - in 26%, moderate - in 55.5%, low - 18.5% of patients. 44 (81.5%) pts continued to take basic anti-rheumatic drugs (DMARDs), 22 (40.8%) pts received steroids, including in combination with DMARDs - 10 (18.6%). Before the operation, and after the 6 months estimated joint pain (VAS), disease activity - DAS28, functional capacity index HAQ were evaluated. In 28 patients the same parameters were assessed after 12 months.
Results Decrease in pain intensity on the VAS was observed in the first month after knee arthroplasty, after 6 months the pain (VAS) decreased almost to 31.9 mm (p<0.05).
Disease activity decreased with HAQ index 1,68±0,94 to 1,15±0,73 (p<0, 05). After 12 months, VAS was 25,4±11,8 mm, HAQ - 1,06±0,63.
6 months after surgery evaluation showed that VAS in patients treated with corticosteroids (n=22) was - 44,2±16,2 mm, receiving DMARDs without corticosteroids (n=32) -35,4±12,1 mm (p<0.05), after 12 months VAS was 30,8±10,6 mm and 21,3±9,6 mm (p<0.05), respectively, in groups. Significantly (p<0.05) was observed than the positive dynamics in relation to the functional capacity of patients in the group receiving DMARDs with corticosteroids (HAQ 6 months -0,98±0,64, 12 months- 0,89±0,56) compared with patients receiving basic therapy without corticosteroids (HAQ 6 months -1,23±0,69, 12 months- 1,14±0,61)
Conclusions Knee joint arthroplasty is an effective method to improve functional capacity, pain relief in gonarthrosis and reduces inflammatory activity. Joint function after surgery and in the remote period is better for patients receiving DMARDs compared to patients receiving corticosteroids.
Disclosure of Interest None declared
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