ISSN: 1449-1907International Journal of Medical Sciences
Global reach, higher impact
Int J Med Sci 2024; 21(6):994-1002. doi:10.7150/ijms.93457 This issue Cite
Research Paper
Increased Risk of New-Onset Rheumatoid Arthritis Among Osteoarthritis Patients Received Total Knee Arthroplasty: a global federated health network analysis
1. Department of Medical Education and Research, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
2. Evidence-based Medicine Center, Chung Shan Medical University Hospital, Taichung, Taiwan.
3. Library, Chung Shan Medical University Hospital, Taichung, Taiwan.
4. School of Medicine, Chung Shan Medical University, Taichung, Taiwan.
5. Department of Neurosurgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.
6. School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
7. Department of Medical Education, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
8. Orthopedics Department, Chi-Mei Medical Center, Tainan, Taiwan.
*Dr. Zong-Han Lin and Hui-Chin Chang contributed equally and share the first authorship equally.
#Dr. Yu-Lun Wu and Shuo-Yan Gau contributed equally and share the corresponding authorship equally.
Abstract
Background: Complications of total knee arthroplasty (TKA) had been widely discussed. However, whether TKA influence risk of rheumatoid arthritis (RA) in osteoarthritis patients remained uncertain. We intend to evaluate the risk of RA in osteoarthritis patients underwent TKA.
Methods: In this retrospective cohort study, data was retrieved from the US collaborative networks in TriNetX research network. Within the study period between 2005 and 2017, osteoarthritis patients underwent TKA were enrolled as case cohort whereas osteoarthritis patients never underwent TKA were enrolled as control cohort. Covariates were matched via propensity score matching. Risk of RA in TKA patients were valuated under various follow-up time and sensitivity models.
Results: Under 1-year, 3-year and 5-year of follow-up, TKA patients were associated with significantly elevated risk of RA, especially under 1-year follow-up (HR=1.74; 95% CI, 1.39-2.18). Subgroup analysis demonstrated a significant increase in the risk of RA following TKA in the female subgroup (HR=1.42; 95% CI, 1.24-1.63), the subgroup aged 18-64 years (HR=1.48; 95% CI, 1.11-1.97), and the subgroup aged greater than 65 years old (HR=1.38; 95% CI, 1.21-1.58) based on 5-year follow-up.
Conclusion: Clinicians should be concerned about uncharted association between TKA and RA reported our current study. Additional prospective studies and in-depth mechanistic inquiries were warranted to determine the causation.
Keywords: osteoarthritis, cohort, epidemiology, electronic medical records, rheumatoid arthritis, real world study
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