Opposing Trends in Total Knee and Hip Arthroplasties for Patients With Rheumatoid Arthritis vs. the General Population-A 14-Year Retrospective Study in Taiwan

Kuan-Kai Tung; Yung-Heng Lee; Chuan-Chao Lin; Cheng-Hung Lee; Mei-Chen Lin; James Cheng-Chung Wei

doi:10.3389/fmed.2021.640275

Opposing Trends in Total Knee and Hip Arthroplasties for Patients With Rheumatoid Arthritis vs. the General Population-A 14-Year Retrospective Study in Taiwan

Front Med (Lausanne). 2021 Apr 20:8:640275. doi: 10.3389/fmed.2021.640275. eCollection 2021.

Authors

Kuan-Kai Tung¹, Yung-Heng Lee^{2

3

4}, Chuan-Chao Lin^{5

6}, Cheng-Hung Lee^{1

7}, Mei-Chen Lin⁸, James Cheng-Chung Wei^{9

10

11}

Affiliations

¹ Department of Orthopedics, Taichung Veterans General Hospital, Taichung, Taiwan.
² Department of Senior Services Industry Management, Minghsin University of Science and Technology, Hsinchu, Taiwan.
³ Department of Recreation and Sport Management, Shu-Te University, Kaohsiung, Taiwan.
⁴ Department of Orthopedics, Cishan Hospital, Ministry of Health and Welfare, Kaohsiung, Taiwan.
⁵ Department of Physical Medicine and Rehabilitation, Chung Shan Medical University Hospital, Taichung, Taiwan.
⁶ School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
⁷ Department of Food Science and Technology, Hung Kuang University, Taichung, Taiwan.
⁸ Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.
⁹ Department of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan.
¹⁰ Institute of Medicine, College of Medicine, Chung Shan Medical University, Taichung, Taiwan.
¹¹ Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan.

Abstract

Objective: To determine the trend of incidence rate of total knee arthroplasty (TKA), total hip arthroplasty (THA), and TKA or THA (major joint arthroplasty, MJA) among rheumatoid arthritis (RA) population and compared them with general population (GP) in Taiwan. Methods: Incidence rates and trends of TKA, THA, and MJA were determined over a 14-year period (2000-2013) among RA patients and compared them with GP. RA of patients was diagnosed based on the ACR 1987 criteria and extracted from GP. Subanalyses of incidences of TKA, THA, and MJA by year, 10-year age group, and gender were further conducted for demographic analysis. Patient profiles were extracted from the National Health Insurance Research Database (NHIRD) for interrupted time-series analysis and cohort studies. Results: Patients enrolled were 168,457 receiving TKA, 64,543 receiving THA, and 228,191 receiving MJA surgery. Incidences of TKA, THA, and MJA in RA patients were significantly lower by 49.0, 41.5, and 41.0% compared with concomitantly rises in GP by 131.0, 25.1, and 90.0% among the GP during the study period. The dominant age population for TKA, THA, and MJA were those aged 70-79 years in both GP and RA groups. Conclusions: We found an opposing trend in incidence of TKA, THA, and MJA between RA patients and the GP. The possible influence of pharmacological treatment is implicated for the lower incidence rates of TKA, THA, and MJA surgeries among RA patients.

Keywords: big data and analytics; pharmacological influences; population-based; rheumatoid arthritis; total hip arthroplasty; total knee arthroplasty.