title: Hip score and disease activity correlation in patients with rheumatoid arthritis after total hip arthroplasty.
abstract: OBJECTIVE
  The disease activity score including 28 joints (DAS28), the simplified disease activity index and the clinical disease activity index (CDAI) were developed in order to provide a quantifiable measure of rheumatoid arthritis (RA) activity. Although inflamed hip joints greatly impact activities of daily living (ADL) and walking ability, the hip joint was not included in the DAS28, SDAI or CDAI assessments. Although excellent clinical results have been reported for total hip arthroplasty (THA) in RA patients, correlations between disease activity and hip function in RA patients after THA remain unknown.
  
  
  METHODS
  We analysed the effect of RA disease activity on a hip function score in an observational cohort of RA patients after THA. Twenty-five registered RA patients who had undergone THA (33 joints) were included. Hip function was recorded and RA disease activity was measured on the same day. The mean age of the patients was 65.17 years. They were followed up for a mean of 5.24 years after surgery. The mean duration of disease following RA diagnosis for this patient group was 19.47 years. The Japanese Orthopaedic Association (JOA) hip score was used as a clinical outcome measure for hip dysfunction. RA disease activity and health-related quality of life were measured using the DAS28, SDAI, CDAI and the modified health assessment questionnaire (MHAQ).
  
  
  RESULTS
  The mean JOA score for hip function was 80.48 at the final follow-up. The mean DAS28-ESR, DAS28-CRP, SDAI, CDAI and MHAQ measuring RA disease activity levels were 3.38, 2.65, 9.59, 8.63 and 0.44, respectively, at the final follow-up. There was a significant negative correlation between the JOA hip score and all disease activity assessments observed after THA (DAS-ESR [P = 0.0067], DAS-CRP [P = 0.0008]), SDAI [P = 0.0034], CDAI [P = 0.0003]) and MHAQ [P = 0.0002]).
  
  
  CONCLUSIONS
  We found significant negative correlations between JOA hip scores and all disease activity assessments in RA patients treated with THA.
authors: Department of Orthopaedic Surgery, Mie University Graduate School of Medicine, 2-174 Edobashi, Tsu, Mie 514-8507, Japan. whiroki@clin.medic.mie-u.ac.jp
authors: Hiroki
authors: H
authors: Wakabayashi
authors: Masahiro
authors: M
authors: Hasegawa
authors: Kakunoshin
authors: K
authors: Yoshida
authors: Kusuki
authors: K
authors: Nishioka
authors: Akihiro
authors: A
authors: Sudo
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000503:physiopathology / Q000601:surgery*; D019644:Arthroplasty, Replacement, Hip; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006621:Hip Joint / Q000502:physiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D016059:Range of Motion, Articular / Q000502:physiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome
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