Comparison of Postoperative Pain and Clinical Outcomes of Total Knee Arthroplasty Among Patients with Rheumatoid Arthritis and Osteoarthritis Referred to Clinic or Emergency Department

Mehdi Teimouri; Mohammad Àzad Majedi; Alireza Hosseini; Mohsen Aliakbari; Mehdi Motififard; Amirmohammad Taravati; Fatemeh Zand; Amirhossein Sadeghian; Mohammad Bakhtiari Moghadam

doi:10.4103/abr.abr_105_23

Comparison of Postoperative Pain and Clinical Outcomes of Total Knee Arthroplasty Among Patients with Rheumatoid Arthritis and Osteoarthritis Referred to Clinic or Emergency Department

Adv Biomed Res. 2023 Oct 28:12:244. doi: 10.4103/abr.abr_105_23. eCollection 2023.

Authors

Mehdi Teimouri¹, Mohammad Àzad Majedi², Alireza Hosseini³, Mohsen Aliakbari⁴, Mehdi Motififard¹, Amirmohammad Taravati⁴, Fatemeh Zand⁴, Amirhossein Sadeghian⁵, Mohammad Bakhtiari Moghadam⁴

Affiliations

¹ Department of Orthopedic Surgery, School of Medicine, Kashani University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran.
² Department of Anesthesiology, Faculty of Medicine, Kurdistan University of Medical Sciences, Sanandaj, Iran.
³ Department of Orthopaedic Surgery, Vitos Orthopaedic Clinic Kassel GmbH, Kassel, Germany.
⁴ Department of Orthopedic Surgery, School of Medicine, Isfahan University of Medical Science, Isfahan, Iran.
⁵ Department of Orthopedic Surgery, School of Medicine, Zabol University of Medical Sciences, Sistan and Baluchestan Province, Iran.

Abstract

Background: Total knee arthroplasty (TKA) is among the most frequent orthopedic procedures. TKA has been shown to provide significant benefits to patients with rheumatoid arthritis (RA) and osteoarthritis (OA). We hypothesized that patients undergoing primary TKA with diverse preoperative diseases would have varying expectations for both pain and function following TKA.

Materials and methods: Patients diagnosed with OA or RA participated in this prospective cohort investigation. We assessed variables including Knee society score (KSS), and patient's quality of life using 36-Item Short Form Survey Instrument (SF-36). Pain was also measured using the Visual Analogue Scale (VAS).

Results: In this study, 606 patients including 412 females and 194 males with a mean age of 65.5 ± 8.7 years were included in the study. Among patients, 46 patients underwent TKA due to RA and 560 patients due to knee OA. There was no statistically significant difference in term of KSS clinical score before the operation (P = 0.101). The mean of KSS clinical score and functional score variables at 6 months and 12 months after the operation were higher in OA group in comparison to RA group. SF-36 was significantly improved in OA group in comparison to RA group. Also, VAS in the RA group is significantly higher than in the OA group after 12 months of follow-up.

Conclusion: Our results demonstrate that patients with OA after TKA have better KSS clinical and functional results than patients with RA.

Keywords: Arthritis; knee society score; osteoarthritis; rheumatoid; total knee arthroplasty.