title: Reduction in orthopaedic surgery in patients with rheumatoid arthritis: a Norwegian register-based study.
abstract: OBJECTIVE
  The disease course of patients with rheumatoid arthritis (RA) has become milder in recent years. In this study we investigated the incidence of orthopaedic surgery in patients with RA.
  
  
  METHODS
  From the Norwegian Arthroplasty Register we selected joint replacement procedures conducted during the years 1994-2012 (n = 11 337), and from the Norwegian Patient Register we obtained data on synovectomies (n = 4782) and arthrodeses (n = 6022) during 1997-2012. Using Poisson regression we analysed the time trends in the incidence of procedures performed.
  
  
  RESULTS
  There was a significant decrease in the incidence of arthroplasty surgery (coefficient of -0.050 per year) and synovectomies (coefficient of -0.10) and a declining trend of arthrodeses in patients with RA in the study periods. The greatest reduction was found in procedures involving the wrist and hand.
  
  
  CONCLUSIONS
  We found a decrease in orthopaedic surgery in patients with RA that continued into the biologic era and throughout the study period. The general increasing trend in the use of synthetic and biological disease-modifying anti-rheumatic drugs (DMARDs) thus coincides with less joint destruction and an improved long-term prognosis of patients with RA.
authors: a Department of Rheumatology , Haukeland University Hospital , Bergen , Norway.|b The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery , Haukeland University Hospital , Bergen , Norway.
authors: T W
authors: TW
authors: Nystad
authors: b The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery , Haukeland University Hospital , Bergen , Norway.
authors: A M
authors: AM
authors: Fenstad
authors: b The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery , Haukeland University Hospital , Bergen , Norway.|c Department of Clinical Medicine (K1) , University of Bergen , Norway.
authors: O
authors: O
authors: Furnes
authors: b The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery , Haukeland University Hospital , Bergen , Norway.|c Department of Clinical Medicine (K1) , University of Bergen , Norway.
authors: L I
authors: LI
authors: Havelin
authors: b The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery , Haukeland University Hospital , Bergen , Norway.
authors: A K
authors: AK
authors: Skredderstuen
authors: a Department of Rheumatology , Haukeland University Hospital , Bergen , Norway.|b The Norwegian Arthroplasty Register, Department of Orthopaedic Surgery , Haukeland University Hospital , Bergen , Norway.|d Section for Rheumatology, Department of Clinical Sciences (K2) , University of Bergen , Norway.
authors: B-Ts
authors: BT
authors: Fevang