The effect of rheumatological support on the postoperative prognosis after hip arthroplasty in patients with rheumatoid arthritis

Abstract

Objective. To assess the impact of systematic rheumatologic supervision on the outcomes of total hip arthroplasty (THA) in patients with rheumatoid arthritis (RA) through retrospective analysis. Materials and methods. This study analyzed data from 194 RA patients who underwent primary THA. The main group (n=143) received regular rheumatologic care, while the comparison group (n=51) did not. Outcomes assessed included the presence of osteoporosis, acetabular defects, intraoperative blood loss, surgical techniques, and functional results. Results. Patients under regular rheumatologic care had a lower incidence of osteoporosis (47.6 % vs. 70.6 %; p=0.0054), reduced blood loss (320±102 ml vs. 375±110 ml), and better clinical outcomes (DAS 28 improved from 4.6 to 2.6; p<0.01; short-HAQ and Harris Hip Scores also improved). Those without rheumatologic supervision required more frequent bone grafting and screw fixation. The highest blood loss was observed in patients   receiving glucocorticoids (up to 450 ml; p<0.0001). Conclusion. Systematic rheumatologic management before, during, and after THA significantly reduces surgical risks and improves both anatomical and clinical outcomes in RA patients. It should be considered an essential component of comprehensive care in joint replacement surgery.