title: Effect of total knee arthroplasty on other joints in patients with rheumatoid arthritis evaluated by 18-FDG-PET.
abstract: OBJECTIVE
  The objective of this study was to assess arthritis of the whole body before and after total knee arthroplasty (TKA) in patients with rheumatoid arthritis (RA) using positron emission tomography (PET).
  
  
  METHODS
  Seventeen knees of 17 RA patients (median age 68 years) who underwent TKA were included in this study. Clinical assessments of disease activity, knee function and activities of daily living (ADL) were performed before and after TKA.18Fluorodeoxyglucose (FDG)-PET was performed preoperatively and 12 weeks postoperatively when RA disease activity was assessed. The maximal standardized uptake value (SUV) in the region of interest was used to assess FDG uptake.
  
  
  RESULTS
  Disease activity and knee function improved in all patients after TKA. There was a significant decrease in the number of patients with swollen or tender joints involving the right wrist, right knee and left knee. The SUV of bilateral wrist joints decreased significantly 12 weeks after TKA, whereas the SUVs of other large joints were unchanged.
  
  
  CONCLUSIONS
  TKA can improve not only ADL and knee function, but also the disease activity index in RA patients. However, TKA has limited effectiveness against synovitis of the joints not undergoing surgery.
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yonemoto
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Okamura
authors.affiliation: Department of Orthopaedic Surgery, Inoue Hospital, Takasaki, Gunma, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kaneko
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Chisa
authors.initials: C
authors.lastname: Okura
authors.affiliation: Department of Physical Therapy, Takasaki University of Health and Welfare, Takasaki, Gunma, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Takahito
authors.initials: T
authors.lastname: Suto
authors.affiliation: Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tsushima
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Takagishi
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee; D001696:Biomechanical Phenomena; D003287:Contrast Media / Q000008:administration & dosage*; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000008:administration & dosage*; D006801:Humans; D007719:Knee Joint / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011237:Predictive Value of Tests; D020127:Recovery of Function; D013585:Synovitis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome; D051598:Whole Body Imaging / Q000379:methods*; D014955:Wrist Joint / Q000000981:diagnostic imaging* / Q000503:physiopathology
chemical_list: D003287:Contrast Media; D019788:Fluorodeoxyglucose F18
keywords: 18-FDG-PET; biologic agents; rheumatoid arthritis; synovitis; total knee arthroplasty