Background Elderly people over 65 year-old have increased year by year in many countries1. Because their rate was from 19.5% at 2005 to 25.1% at 2014 in Japan, the numbers of total joint arthroplasties have increased too. On the other hand, modern treatments for rheumatoid arthritis (RA) have drastically changed in the last decade. The rate of orthopaedic surgery, especially total joint arthroplasty, may reflect trends in disease severity of RA, management and health outcomes2,3.
Objectives The aim of this study was to analyze the trend of total joint arthroplasties for RA patients and osteoarthritis (OA) patients in our institutes in the last decade.
Methods We surveyed the number and rate of orthopaedic surgeries and total joint arthroplasties in our three institutes from 2004 to 2013.
Results We had 19,833 cases of orthopaedic surgeries, including 6,962 total joint arthroplasties in the last decade. They have increased year by year (r=0.9, p<0.05). They have been suffered by OA (82%, 5,697 cases); trauma (6%, 393 cases); RA (5%; 358 cases), loosening of implants (4%), osteonecrosis (2%), infection (0.7%), dislocation of total joint arthroplasty (0.3%) (Fig. 1). The rate of OA (r=0.9), osteonecrosis (r=0.8) and infection (r=0.8) were related to total numbers of orthopaedic surgeries.They contained 3,165 cases of total hip arthroplasties (45%), 2561 total knee arthroplasty (37%), 453 bipolar hip prosthesis (7%), 317 unilateral knee arthroplasty (0.3%), 340 revision of total hip arthroplasties (5%), 41 revision of total knee arthroplasties (0.6%), 22 bipolar shoulder prosthesis (0.3%), 21 total ankle arthroplasties (0.3%), 3 swanson arthroplasty for fingers and 2 total shoulder arthroplasties. The rate of total hip arthroplasties (r=0.9), total knee arthroplasties (r=0.9), unilateral knee arthroplasties (r=0.9) and revision of total knee arthroplasties (r=0.8) were related to total numbers of orthopaedic surgeries.
Conclusions The rate of total joint arthroplasties were increased year by year, and related to total numbers of orthopaedic surgeries. Trend of total joint arthroplasties for RA patients compared to OA patients has decreased in our institutes in the last decade because of increasing of elderly people and improving of the treatment for RA4.
Ethgen O and Reginster JY. Ann Rheum Dis, 2004.
Gillam MH, Osteoarthritis Cartilage, 2012.
Ravi B, Arthritis Rheum, 2012.
Momohara S, J Rheumatol, 2014.
Disclosure of Interest None declared