title: Functional Evaluation of Patients Undergoing Multiple Joint Replacements: A Retrospective Study of 50 Patients with a Minimum of Six Months of Follow-up.
abstract: BACKGROUND
  Polyarthritis is a challenging condition that an orthopedic surgeon faces in day-to-day practice. Some of the conditions where multiple joints are affected are rheumatoid arthritis, osteoarthritis, and ankylosing spondylitis. Multiple joint afflictions can cause severe impairment in the quality of life, which leads to a significant socioeconomic burden on the family and society. Joint replacement is considered as a treatment when severe joint pain or dysfunction is not alleviated by conservative management. Total joint arthroplasty remains one of the most commonly performed and universally accepted operative interventions for such patients.
  
  
  METHODS
  Fifty patients were invited into the study. All patients included in the study were 18 years of age and older and had undergone two or more joint replacements with a minimum of six months duration from the last surgery. The data was collected during the preoperative and postoperative periods through patient records and questionnaires. The Short Form 36 Health Survey Questionnaire (SF-36) scores were generated from an online application that is readily available on the official website SF-36 scoring system. The results were compared, analyzed, and tested for significance using the Wilcoxon signed rank test.
  
  
  RESULTS
  The highest incidence of multiple joint replacements appears to be in the age-group of 51 - 70 years (52%), the mean age of patients being 51.7 +/- 14.4 years. The ratio of female to male patients was 1.6:1. On comparison of preoperative and postoperative (six months) physical component and mental component scores, the differences were found to be significant (p-value: < 0.01). This finding is irrespective of the diagnosis, gender, or age of the patient.
  
  
  CONCLUSIONS
  In the study conducted on 50 patients, we found out that multiple joint arthroplasties are fruitful surgeries. The procedures are efficient in reducing the disabilities seen in patients with polyarthritis of various causes and improving the overall quality of life. We strongly recommend multiple joint arthroplasties to patients with severe disability. However, adequate medical management plays an equally important role to improve the overall results. Well-designed and larger studies are required to establish the treatment protocols and order of surgeries in patients with differing causes of polyarthritis.
authors.affiliation: Professor & Unit Head, Department of Orthopaedics, Seth GS Medical College & KEM Hospital, Mumbai, India.
authors.forename: Shubhranshu S
authors.initials: SS
authors.lastname: Mohanty
authors.affiliation: Department of Orthopaedics, KEM Hospital, Mumbai.
authors.forename: Nandan
authors.initials: N
authors.lastname: Mishra
authors.affiliation: Orthopedics, LTMMC and GH, Mumbai.
authors.forename: Prateek
authors.initials: P
authors.lastname: Patil
authors.affiliation: Department of Orthopaedics, KEM Hospital, Mumbai.
authors.forename: Ajinkya
authors.initials: A
authors.lastname: Desale
keywords: mental component scores; multiple joint arthroplasties; physical component scores; polyarthritis; sf-36 scores