The Observation Of Disease Activity And Efficacy With Active Rheumatoid Arthritis After Total Knee Arthroplasty

Objective and significance: This study aimed to assess changes in disease activity and obsere the efficacy after total knee arthroplasty(TKA) in patients with active rheumatoid arthritis(RA), to accumulated basic theory and clinical data for the treatment of active RA patients after TKA and discuss the key points of operation to guide the clinical operation.Method: Collected the clinical data of 34 patients(49 knees) with activity RA, who have undergone TKA operation and postoperative accept drug treatment in our hospital Joint Center during the period of January 2013 to June 2015, for the surgical treatment group; Collected the clinical data of 30 patients with activity RA, who have Simple accept drug treatment in our hospital Rheumatology the period of May 2013 to May 2015, for the simple drug treatment group, as the control group. Two groups of patients were followed up to collect the clinical data after treatment 6 month. The changes of disease activity were evaluated by comparing rheumatoid factor(RF), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and simplified disease activity index(SDAI); the efficacy were evaluated by Hospital for Special Surgery(HSS) score and the ranges of motion(ROM) of the knees.Result: A total of 30 patients(44 knees) were included in the surgical treatment group. A total of 30 patients in the drug treatment group were included in this study. The gender, age, course of disease, SDAI score, ESR, CRP and RF were no different in the two groups(P >0.05).1. The SDAI score, ESR, CRP, RF in two group were decreased after treatment, the difference was statistically significant(P < 0.05), the SDAI score, ESR, CRP, RF of surgical treatment group decreased significantly compared with the drug treatment group after treatment, the difference was statistically significant(P < 0.05). All patients in surgical treatment group postoperative SDAI score were higher than 3.3, that they all still in active stage.2. The HSS scores and pain of HSS and function of HSS, strength of HSS, buckling of HSS, stability of HSS of Active RA patients with TKA improved obviously, the difference compared with the preoperative had statistically significant(P < 0.01). The ROM of the knee joint at active RA patients after TKA was significantly improved, the difference was statistically significant(P < 0.01).Conclusion: TKA not only significantly improve the knee joint function, but also decrease the disease activity in patients with active RA. But RA is still in the active stage, should continue with normative medicine treatment actively to achieve clinical remission.