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Related Experiment Videos

Outcome from multiple joint replacement surgery to the lower limbs.

D J Walker1, K Usher, M O'Morchoe

  • 1Department of Rheumatology, Freeman Hospital, Newcastle on Tyne.

British Journal of Rheumatology
|April 1, 1989
PubMed
Summary

Patients undergoing major joint replacement for inflammatory arthritis reported satisfaction due to pain relief and improved function. Despite remaining disabled, they avoided permanent inpatient care, indicating functional gains from surgery.

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Area of Science:

  • Orthopedic Surgery
  • Rheumatology
  • Rehabilitation Medicine

Background:

  • Major joint replacement is a common procedure for end-stage arthritis.
  • Rheumatoid arthritis (RA) and other inflammatory arthropathies pose unique challenges post-surgery.
  • Assessing long-term outcomes in these complex patient groups is crucial.

Purpose of the Study:

  • To evaluate the outcomes of patients with inflammatory arthritis who underwent multiple major joint replacements.
  • To assess functional improvement, pain relief, and patient satisfaction after surgery.
  • To compare outcomes with expected results and identify factors influencing patient well-being.

Main Methods:

  • Retrospective review of operation records for patients with three or more major joint replacements (hips/knees).

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  • Inclusion of patients with rheumatoid arthritis, osteoarthritis, and psoriatic arthritis.
  • Assessment of outcomes including range of motion, pain, satisfaction, mobility, disability (HAQ score), and social impact.

    • Main Results:

    • Thirty-six surviving rheumatoid arthritis patients had an average follow-up of 1.8 years.
    • Eight patients died post-operatively, a higher-than-expected rate.
    • Surviving patients reported satisfaction driven by pain relief and functional gains, despite a high mean HAQ score of 2.75.
    • No patient required permanent inpatient care.

    Conclusions:

    • Major joint replacement offers significant pain relief and functional improvement for patients with inflammatory arthritis.
    • While these patients remain functionally disabled, surgical outcomes contribute positively to their quality of life.
    • The higher mortality rate warrants further investigation in the context of advanced inflammatory arthritis and joint replacement.