OUTCOMES FOR PATIENTS UNDERGOING ONE OR MORE TOTAL HIP AND KNEE ARTHROPLASTIES

Either total hip arthroplasty (THA), total knee arthroplasty (TKA) or both were performed in 105 patients from 1981 to 1994. These patients were experiencing severe joint destruction in the lower extremities du e to rheumatoid arthritis (RA). These patients were followed for more than 2 years after their last operation. Eighty-six patients were aliv e and 19 patients had died at the time of follow-up. The 86 living pat ients were divided into four groups based on the number of replaced jo ints. Their pre-and postoperative conditions, including such factors a s pain, mobility and disability for the quality of life (QOL), were co mpared. All of the four groups showed some reduction in pain and disab ility, and an improvement in ambulation after the operations. The 19 d eceased patients were classified into two groups, one including those with multiple (three or four) arthroplasties and the other, those with only a small number (one or two). The mean age at death was lower (55 .7 +/- 6.2 years) in patients with multiple arthroplasties than that ( 69.1 +/- 7.5 years) in patients with only a small number of arthroplas ties. Secondary diseases from RA, such as amyloidosis, spinal injury a nd pulmonary fibrosis, were found to be the primary cause of death in patients with multiple arthroplasties. The most important finding in t his study is that although RA patients with multiple arthroplasties in the lower extremities improved their QOL, they were still afflicted w ith secondary diseases derived from RA and experienced complications t hat could shorten their lifespan.