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. 2021 Apr 20:8:640275.
doi: 10.3389/fmed.2021.640275. eCollection 2021.

Opposing Trends in Total Knee and Hip Arthroplasties for Patients With Rheumatoid Arthritis vs. the General Population-A 14-Year Retrospective Study in Taiwan

Kuan-Kai Tung  1 , Yung-Heng Lee  2   3   4 , Chuan-Chao Lin  5   6 , Cheng-Hung Lee  1   7 , Mei-Chen Lin  8 , James Cheng-Chung Wei  9   10   11
Affiliations

Opposing Trends in Total Knee and Hip Arthroplasties for Patients With Rheumatoid Arthritis vs. the General Population-A 14-Year Retrospective Study in Taiwan

Kuan-Kai Tung et al. Front Med (Lausanne). .

Abstract

Objective: To determine the trend of incidence rate of total knee arthroplasty (TKA), total hip arthroplasty (THA), and TKA or THA (major joint arthroplasty, MJA) among rheumatoid arthritis (RA) population and compared them with general population (GP) in Taiwan. Methods: Incidence rates and trends of TKA, THA, and MJA were determined over a 14-year period (2000-2013) among RA patients and compared them with GP. RA of patients was diagnosed based on the ACR 1987 criteria and extracted from GP. Subanalyses of incidences of TKA, THA, and MJA by year, 10-year age group, and gender were further conducted for demographic analysis. Patient profiles were extracted from the National Health Insurance Research Database (NHIRD) for interrupted time-series analysis and cohort studies. Results: Patients enrolled were 168,457 receiving TKA, 64,543 receiving THA, and 228,191 receiving MJA surgery. Incidences of TKA, THA, and MJA in RA patients were significantly lower by 49.0, 41.5, and 41.0% compared with concomitantly rises in GP by 131.0, 25.1, and 90.0% among the GP during the study period. The dominant age population for TKA, THA, and MJA were those aged 70-79 years in both GP and RA groups. Conclusions: We found an opposing trend in incidence of TKA, THA, and MJA between RA patients and the GP. The possible influence of pharmacological treatment is implicated for the lower incidence rates of TKA, THA, and MJA surgeries among RA patients.

Keywords: big data and analytics; pharmacological influences; population-based; rheumatoid arthritis; total hip arthroplasty; total knee arthroplasty.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flowchart of the study selection process.
Figure 2
Figure 2
Comparison of incidence rates of total hip arthroplasty (THA), total knee arthroplasty (TKA), and major joint arthroplasty (MJA) between general hospitalization patients (GP) and rheumatoid arthritis (RA) patients from 2000 to 2013 [per 100,000 person years (pyrs) in GP and per 1,000 pyrs in RA patients].
Figure 3
Figure 3
Incidence ratio of rheumatoid arthritis (RA) patients to general hospitalization patients (GP) from 2000 to 2013 [per 100,000 person years (pyrs) in GP and per 1,000 pyrs in RA patients], indicating the proportion of RA patients receiving total hip arthroplasty (THA), total knee arthroplasty (TKA), and major joint arthroplasty (MJA) among GP cohort.
See this image and copyright information in PMC

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