title: Long-term outcome of patients with rheumatoid arthritis treated by multiple arthroplasty.
abstract: We conducted a study of 82 patients with rheumatoid arthritis (RA) who had undergone multiple arthroplasty and investigated their clinical findings and clinical courses. We reviewed the significance of multiple arthroplasty in the treatment of RA, its problems, and measures to solve them. All patients initially regained and maintained good walking capacity. However, the walking capacity of many patients again decreased over the long term; in the tenth year, 79% of patients were capable of a practical gait. The causes of decreased walking capacity included complications of artificial joints, cervical lesions, and vertebral compression fractures. Fractures were observed in as many as nine patients, indicating that it is important to prevent and treat their cause, that is, osteoporosis. The survival rate was 71% in 10 years. In RA patients, particularly those who have undergone multiple arthroplasty, the major causes of death are infection and rheumatic disease, suggesting that prevention of such diseases should be considered paramount. Appropriate systemic treatment of RA, patient education, and measures against osteoporosis for prevention of complications may preserve the worth of multiple arthroplasty for RA patients with multiple joint destruction.
authors.affiliation: Centre for Rheumatic Disease, Mima Hospital in Yoshinogawa city, 497 Zyougejima, Kamojima, Yoshinogawa, 776-0013, Japan. ayutarou@galaxy.ocn.ne.jp
authors.forename: Fumio
authors.initials: F
authors.lastname: Shinomiya
authors.forename: Noriaki
authors.initials: N
authors.lastname: Mima
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Hamada
authors.forename: Takuya
authors.initials: T
authors.lastname: Fuzimura
authors.forename: Soushi
authors.initials: S
authors.lastname: Matsumoto
authors.forename: Masahiko
authors.initials: M
authors.lastname: Okada
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hamada