title: Rheumatoid arthritis patients undergoing total hip and knee arthroplasty have better in-hospital outcomes compared with non-rheumatoid arthritis patients.
abstract: OBJECTIVE
  Rheumatoid arthritis (RA) is known to be associated with multiple comorbidities and, therefore, overall management is critical for those patients undergoing elective major orthopaedic surgeries, such as total hip arthroplasty (THA) and total knee arthroplasty (TKA). The purpose of this study was to compare in-hospital outcomes of elective THA and TKA between patients with and without RA in the US during the last decade. We hypothesised that patients with RA would have similar perioperative outcomes after elective THA and TKA.
  
  
  METHODS
  Clinical data were derived from the US Nationwide Inpatient Sample (NIS) between 2000 and 2009. Patients who underwent elective THA and TKA were identified. Data regarding patient- and healthcare system-related characteristics, comorbidities, in-hospital complications, and mortality were retrieved. In-hospital outcomes of the procedures were compared between patients with and without RA.
  
  
  RESULTS
  Comparison between patients with and without RA showed that patients with RA had significantly lower overall in-hospital complication rates following THA and TKA, and lower in-hospital mortality rate following THA. Patients with RA undergoing THA and TKA had decreased risk of overall in-hospital complications compared to those without RA.
  
  
  CONCLUSIONS
  Contrary to our hypothesis, perioperative outcomes of elective THA and TKA in patients with RA were better than those in patients without RA. These results may indicate that patient selection and pre- and perioperative management of patients with RA undergoing elective THA and TKA were well conducted in the US during the last decade.
authors.affiliation: Dept. of Orthopaedic Surgery & Rehabilitation Medicine, SUNY Downstate Medical Center, NY, USA; and Dept. of Orthopaedic Surgery, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. hiroyoshihara55@yahoo.co.jp.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yoshihara
authors.affiliation: Department of Statistical Sciences, School of Multidisciplinary Sciences, The Graduate University for Advanced Studies, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Yoneoka
authors.affiliation: Department of Orthopaedic Surgery & Rehabilitation Medicine, SUNY Downstate Medical Center, NY, USA.
authors.forename: Adam
authors.initials: A
authors.lastname: Margalit
authors.affiliation: Department of Orthopaedic Surgery Hospital for Joint Diseases, New York University Langone Medical Center, NY, USA.
authors.forename: Joseph D
authors.initials: JD
authors.lastname: Zuckerman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001172:Arthritis, Rheumatoid / Q000150:complications*; D019644:Arthroplasty, Replacement, Hip / Q000009:adverse effects* / Q000401:mortality; D019645:Arthroplasty, Replacement, Knee / Q000009:adverse effects* / Q000401:mortality; D017558:Elective Surgical Procedures; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D016896:Treatment Outcome