Palm T M, Kaarela K, Hakala M S, Kautiainen H J, Kröger H P J, Belt E A
Department of Orthopaedics, Rheumatism Foundation Hospital, Heinola, Finland.
Clin Exp Rheumatol. 2002 May-Jun;20(3):392-4.
The aim of the present study was to evaluate the number and sequence of large joint replacements (LJR) performed in long-term rheumatoid arthritis (RA) from an inception cohort of 103 patients with rheumatoid factor (RF)-positive RA followed over 25 years.
A total of 83 patients attended the 15-year and 68 patients the 20-year follow-up. Patient documents and radiographs were evaluated in the beginning of 2001 and a complementary interview was arranged to assess the number and sequence (timing) of LJRs performed.
The cumulative number of LJRs performed for 22 patients (19 women) during the 25 years of follow-up was 41. Seventeen total hip joint replacements (THR) (42% of the total number of 41 LURs) were performed on 13 patients, median time from the diagnosis to the operation being 14 years; 14 total knee replacements (TKR) (34%) on 11 patients (after a median time of 17 years); 3 total shoulder replacements (TSR) (7%) on 3 patients (median time of 18 years); and 7 total elbow replacements (TER) (17%) on 4 patients (median time of 21 years), respectively. Six patients had undergone three or more LJRs during the follow-up period.
During our 25 years of follow-up, in 27% of RA patients LUR was needed, and 41% of them needed more than one replacement.
本研究旨在评估从103例类风湿因子（RF）阳性类风湿关节炎患者的起始队列中选取的患者，在长达25年的长期类风湿关节炎（RA）病程中进行的大关节置换术（LJR）的数量和顺序。
共有83例患者参加了15年随访，68例患者参加了20年随访。2001年初对患者病历和X光片进行了评估，并安排了补充访谈以评估所进行的LJR的数量和顺序（时间）。
在25年的随访期间，22例患者（19名女性）进行的LJR累计数量为41次。13例患者进行了17次全髋关节置换术（THR）（占41次LUR总数的42%），从诊断到手术的中位时间为14年；11例患者进行了14次全膝关节置换术（TKR）（34%）（中位时间为17年）；3例患者进行了3次全肩关节置换术（TSR）（7%）（中位时间为18年）；4例患者进行了7次全肘关节置换术（TER）（17%）（中位时间为21年）。6例患者在随访期间接受了三次或更多次LJR。
在我们25年的随访中，27%的RA患者需要进行LUR，其中41%的患者需要进行不止一次置换。
