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Updated: Jul 4, 2025
Knee Arthrocentesis in Adults
Published on: February 25, 2022
Arthroplasty rates and risk in familial Mediterranean fever patients: a large population-based study
Niv Ben-Shabat1,2,3, Lior Fisher1,2,3, Nitzan Maixner1,3,4,5
1Department of Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Israel.
Background:
FMF is a genetic disorder characterized by recurrent episodes of fever and inflammation in various organs, including the joints. Traditionally, the arthritis of FMF has been considered relatively harmless. However, anecdotal evidence has suggested that it may contribute to long-term joint damage, which may necessitate surgical joint replacement. This study aimed to investigate the rates of arthroplasty among FMF patients and compare it with those of the general population.
Methods:
The study used the electronic database of the largest health-care organization in Israel to identify 9769 FMF patients diagnosed between 2000 and 2016. A similar number of age-, gender-, and residency-matched controls were also identified. The rates of arthroplasty were compared between the two groups. A logistic regression model predicting the need for arthroplasty within the FMF group was formed to identify potential risk factors.
Results:
Of the 9769 FMF patients, 114 (1.2%) underwent arthroplasty, compared with 64 (0.7%) of the control group [unadjusted odds ratio (OR) = 1.79, 95% CI 1.32-2.43; partially adjusted OR = 1.97, 95% CI 1.40-2.77; fully adjusted OR = 1.92, 95% CI 1.35-2.72]. Within the FMF cohort, those of North African origin had a significantly higher risk of arthroplasty (OR = 6.89, 95% CI 5.09-9.33; P < 0.001).
Conclusion:
FMF patients can experience long-term joint damage that may require arthroplasty. Although this complication is relatively uncommon in FMF patients, it occurs almost twice as frequently as compared with the general population. FMF patients of North African origin are at an even higher risk.
Insights
Familial Mediterranean Fever (FMF) patients have an increased risk of joint replacement surgery, nearly double that of the general population. Individuals of North African descent with FMF face an even higher risk of needing arthroplasty.
Area of Science:
- Rheumatology
- Genetics
- Epidemiology
Background:
- Familial Mediterranean Fever (FMF) is a genetic autoinflammatory disorder causing recurrent fever and inflammation.
- Joint involvement in FMF is often considered benign, but evidence suggests potential for long-term joint damage.
- Surgical joint replacement (arthroplasty) may be a consequence of FMF-related arthritis.
Purpose of the Study:
- To assess the incidence of arthroplasty in patients with Familial Mediterranean Fever.
- To compare arthroplasty rates in FMF patients versus the general population.
- To identify risk factors for arthroplasty within the FMF cohort.
Main Methods:
- Retrospective cohort study utilizing an Israeli healthcare database (2000-2016).
- Inclusion of 9769 FMF patients and a matched control group.
- Statistical analysis, including logistic regression, to compare arthroplasty rates and identify risk factors.
Main Results:
- 1.2% of FMF patients underwent arthroplasty compared to 0.7% in the control group (OR=1.92).
- FMF patients demonstrated a nearly twofold increased risk of arthroplasty compared to controls.
- FMF patients of North African origin exhibited a significantly higher risk of arthroplasty (OR=6.89).
Conclusions:
- Familial Mediterranean Fever can lead to long-term joint damage requiring arthroplasty.
- Arthroplasty is a more frequent complication in FMF patients than previously assumed.
- Origin, particularly North African, is a significant risk factor for arthroplasty in FMF.
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