How effective is total knee replacement in patients with rheumatoid arthritis?

Studies that have assessed the effects of total knee replacement on quality of life are scarce and have been almost exclusively limited to patients with osteoarthritis, even though rheumatoid arthritis is the most common inflammatory arthritis for which the surgery is indicated.

In a new study that assessed the effects of total knee replacement in rheumatoid arthritis patients versus osteoarthritis patients, researchers found that the surgery is highly effective in reducing knee pain and also provides benefits in other subjective quality of life indices in patients with rheumatoid arthritis. Improvements were not as great as those experienced by osteoarthritis patients, however.

The investigators concluded that total knee replacement can serve as a "time machine" via which patients can return to a less disabled lifestyle, before the arthritic process catches up.

"A new knee can give osteoarthritis patients 10 to 20 years of painless use, whereas rheumatoid arthritis continues to affect the joint soon afterward. It's an important and effective treatment, but patients with rheumatoid arthritis shouldn't expect the same, often-dramatic results experienced by their osteoarthritis counterparts," said Dr. Kaleb Michaud, senior author of the Arthritis & Rheumatology study. "You've gotten rid of a knee plagued by arthritis, not the arthritis itself. Still, it's an important option that can dramatically improve the patient's quality of life."