Treating Two Knees with One Surgery

RA patients recovering from same day double knee replacement fared as well as OA patients

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Patients with arthritis in both knees sometimes choose to undergo a double replacement surgery on the same day. A recent study looked at whether this operation is safe for rheumatoid arthritis patients.

Researchers compared data on same-day double knee replacements for patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Patients with RA are often considered sicker than OA patients, according to the authors of this study.

The researchers found that RA patients were more likely to have postoperative anemia (not enough healthy red blood cells) and to receive blood transfusions. However, there was not a significant difference in 30-day death rates or complications between the two groups.

The authors of this study concluded that same-day double knee replacement appeared to be safe for healthy candidates with RA.

"Talk to your surgeon about steps to a healthy recovery after knee replacement."

Mark P. Figgie, MD, of the Surgical Arthritis Service at Hospital for Special Surgery, led this study.

Knee replacement surgery is a treatment option for people who have severe arthritis of the knee.

RA is an autoimmune disease — meaning the immune system mistakenly attacks healthy tissues — in which the joints become stiff, swollen and tender.

Patients who have knee RA often have limited mobility and chronic pain.

Arthritis patients sometimes opt to have both knees replaced at the same time. This procedure is called a same-day double knee replacement.

This study looked at how well RA patients fared after a same-day double knee replacement compared to patients with OA, which is often called the "wear and tear" form of arthritis.

According to the authors, patients with OA are often healthier than RA patients, who are more likely to have coexisting conditions like heart disease.

Dr. Figgie and colleagues analyzed data from 240 RA patients and 3,680 OA patients who had same-day double knee replacement surgery between 1998 and 2011.

These researchers compared the groups' rates of death after 30 days and in-hospital complications.

On average, the RA group was younger but had more comorbidities (coexisting health conditions).

Additionally, patients in the RA group stayed in the hospital for a longer time period for the surgery.

The researchers found that there was no difference in 30-day death rates between the RA and OA groups.

The RA patients were more likely to have anemia after the operation. Only 8 percent of OA patients developed postoperative anemia, compared with 17 percent of RA patients.

RA patients also received more blood transfusions than those with OA.

The researchers found that the rates of major and minor complications were similar between the two groups.

The authors of this study concluded that same-day double knee replacements appeared to be as safe in the RA population as they were in the OA population.

They suggested that surgeons coordinate with rheumatologists to determine if an RA patient is healthy enough for the operation.

This study was presented at the annual meeting for the American Academy of Orthopaedic Surgeons on March 13.

The researchers did not disclose funding or conflicts of interest.

Review Date: 
March 18, 2014
Last Updated:
March 19, 2014