Clinical Outcomes After Hip Arthroscopy for Patients With Rheumatoid Arthritis: A Matched-Pair Control Study With Minimum 2-Year Follow-Up
Authors: Ashberg L, Yuen LC, Close MR, Perets I, Mohr MR, Chaharbakhshi EO, Domb BG
Journal: Arthroscopy. 2019 Feb;35(2):434-442.
DOI: 10.1016/j.arthro.2018.08.054 | PMID: 30612769
Background
The effectiveness of hip arthroscopy in patients with rheumatoid arthritis (RA) compared to non-RA patients is unclear.
Methods
Retrospective matched-pair analysis of RA vs. non-RA patients undergoing hip arthroscopy, assessing PRO scores, pain, and secondary surgery rates.
Key Findings
- RA patients had less improvement in PRO scores and lower satisfaction despite similar baseline scores.
- Use of disease-modifying antirheumatic drugs (DMARDs) was associated with slightly better outcomes in RA patients.
- RA patients had higher rates of secondary arthroscopic procedures.
Conclusions
Hip arthroscopy in RA patients results in less functional improvement and higher revision surgery rates compared to non-RA patients.
What Does This Mean for Providers?
- Counsel RA patients regarding the potential for diminished outcomes and increased need for revision surgery after hip arthroscopy.
- Consider optimization of RA disease activity, including DMARD therapy, prior to surgery.
- Careful patient selection and setting realistic expectations are crucial in this population.