Journal of Shandong University (Health Sciences) ›› 2024, Vol. 62 ›› Issue (10): 62-67.doi: 10.6040/j.issn.1671-7554.0.2024.0437

• Special Topic on Enhanced Recovery after Orthapaedic Surgery • Previous Articles    

Clinical outcomes comparison of total knee arthroplasty in patients with rheumatoid arthritis and osteoarthritis under the concept of enhanced recovery after surgery

JIANG Rendong*, ZHAO Jianli*, SHI Chao, HE Yeteng, YUAN Zhen   

  1. Department of Joint and Sport Surgery, The First Affiliated Hospital of Shandong First Medical University &
    Shandong Provincial Qianfoshan Hospital, Jinan 250014, Shandong, China
  • Published:2024-10-12

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Abstract: Objective To compare the early complications and clinical outcomes of total knee arthroplasty(TKA)for end-stage rheumatoid arthritis(RA)and osteoarthritis(OA)under the concept of enhanced recovery after surgery(ERAS). Methods A retrospective analysis was conducted on the clinical data of 96 patients with TKA in the Department of Joint and Sports Medicine at the First Affiliated Hospital of Shandong First Medical University. The patients were divided into RA group(n=25)and OA group(n=71). The intraoperative and postoperative blood loss, incidence of anemia, and postoperative complications such as superficial and deep infections were compared between the two groups. The early clinical outcomes of the patients were evaluated using the Forgotten Joint Score-12(FJS-12)at 1 year postoperatively. Results The proportion of moderate and severe anemia postoperatively was higher in the RA group compared to the OA group ［9(36.0%)vs. 11(15.5%), P=0.030］. There were no significant differences in intraoperative, postoperative, and total blood loss between the two groups(P>0.05). No statistically significant differences were observed in the occurrence of complications such as deep venous thrombosis, pulmonary embolism, superficial and deep infections, and rehospitalization within 90 days postoperatively between the two groups(P>0.05). The FJS-12 score at 1 year postoperatively was lower in the RA group compared to the OA group［(71.28±13.45)vs.(77.59±10.10, P=0.016)］, and the proportion of patients achieving a forgotten joint status was higher in the OA group compared to the RA group ［1(4.0%)vs. 17(23.9%), P=0.035］. However, there was no significant difference in the passing rate between the two groups. Conclusion Under the ERAS concept, the incidence of moderate and severe anemia and length of stay in RA patients after TKA are higher than those of OA patients, while OA patients are more likely to experience a forgotten knee after TKA. Orthopedic surgeons should focus on correcting preoperative anemia in RA patients and continuously optimize the ERAS protocol for these patients.

Key words: Rheumatoid, Osteoarthritis, Total knee arthroplasty, Enhanced recovery after surgery, Forgotten knee score

CLC Number: 

  • R684.3
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