AB0212 FUNCTION AND PAIN IN KNEE JOINTS IN PATIENTS WITH RHEUMATOID ARTHRITIS AFTER TOTAL KNEE ARTHROPLASTY

<h3>Background</h3> Total knee arthroplasty (TKA) in patients with rheumatoid arthritis (RA) is considered the most effective intervention reducing knee pain and improving physical function. However, higher risk of late complication and worse surgery outcomes may be observed in patients with active disease.^[1] <h3>Objectives</h3> To study the knee joint function and pain before and after the TKA in patient with rheumatoid arthritis. <h3>Methods</h3> 69 RA patients (10 (14,5%) males and 59 (85,5%) females) with an average age of 59 [52; 64] years were included into the study group. 81 osteoarthritis (OA) patients (38 males (46,9%) and 43(53,1%) females) aged 66 [61; 73] years, were included into the control group. 23,2% of RA patients had a highly active disease at the moment of intervention. All patients underwent cemented TKA and completed Oxford Knee score (OKS) before the surgery, after discharge and 3 and 12 months after the surgery. Knee pain was assessed using VAS score also before intervention, straight after and 3 and 12 months after the surgery. All analyses were performed using SPSS version 23.0 (IBM Corp., Armonk, NY, USA). A p value of less than 0.05 was considered statistically significant. <h3>Results</h3> Patients in RA group had significantly lower preoperative OKS results, than OA patients (25.0 [23.5; 27.0] versus 29.0 [26.5: 30.0], p=0.00, Mann-Whitney) as well as lower postoperative OKS results before the discharge (34.0 [34; 38] versus 40.0 [35; 40] p=0.00, Mann-Whitney). 3 months after the intervention OKS scores were comparable within the two groups (43.0 [42; 44] versus 43.0 [42; 44], p=0.557; Mann-Whitney). The same was found for OKS scores 12 months after the surgery (44.0 [44; 47] versus 44.0 [44; 47], p=0.328, Mann-Whitney). Pain intensity in RA patients varied from 60 to 90 mm according to VAS prior to surgery and was lower than among OA patients (80.0 [80; 90] versus 90.0 [80; 100], p=0.00, Mann-Whitney) which can be explained by patients’ higher pain tolerance due to “usual” pain in RA. The same tendency was observed immediately after the intervention (55.0 [50; 60] versus 65.0 [50; 65], p=0.00, Mann-Whitney). 3 months after the surgery pain intensity was similar in both groups (30.0 [30; 35], p=0.349, Mann-Whitney). 1 year after the intervention RA patients reported higher VAS scores probably due to RA activity (20.0 [20; 20] versus 10.0 [10; 15], p=0.00, Mann-Whitney). <h3>Conclusion</h3> The effectiveness of TKA for pain reduction and improvement of knee function in patients with RA was comparable to that among patients with OA. OKS scores were lower in RA group prior to surgery, however, 3 and 12 months after the intervention they did not differ between the patients with RA and OA. <h3>Reference</h3> [1]Lee DK, Kim HJ, Cho IY, Lee DH. Infection and revision rates following primary total knee arthroplasty in patients with rheumatoid arthritis versus osteoarthritis: a meta-analysis. Knee Surg Sports Traumatol Arthrosc. 2017 Dec;25(12):3800-3807. doi: 10.1007/s00167-016-4306-8. Epub 2016 Sep 7. PMID: 27605127. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.

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