Yasui Tetsuro, Nishino Jinju, Shoda Naoko, Koizumi Yasuhiko, Ohashi Satoru, Kadono Yuho, Tanaka Sakae, Tohma Shigeto
a Department of Orthopaedic Surgery , Faculty of Medicine, The University of Tokyo , Tokyo , Japan.
b Department of Orthopaedic Surgery , Teikyo University Mizonokuchi Hospital , Kanagawa , Japan.
Mod Rheumatol. 2016;26(1):36-9. doi: 10.3109/14397595.2015.1045258. Epub 2015 Jun 15.
The aim of this study was to clarify the prevalence and the predictive factors for undergoing total knee arthroplasty (TKA) among patients with rheumatoid arthritis (RA).
The data of 1,134 patients with RA who were enrolled in the Japanese nationwide cohort database NinJa in 2003 and consecutively followed up until 2009 were analyzed.
Seventy-six patients underwent TKA during the observation period. The yearly progression of the modified Health Assessment Questionnaire or mHAQ score from 2003 to 2004, but not the yearly progression of the Disease Activity Score in 28 Joints or DAS28 or patient visual analog scale (VAS) score, was significantly higher in the patients who underwent TKA than those who did not. Multivariate analysis showed that knee involvement in the disease, high Steinbrocker stage (III or IV), and high patient VAS score at the time of enrollment were powerful predictive factors, with hazard ratios of 4.01, 3.71, and 1.20, respectively. According to survival analysis with TKA as an endpoint, patients with knee involvement in the disease at the time of enrollment had a significantly worse 5-year survival rate than did those without knee involvement (83.5% vs. 97.0%, respectively).
Several factors were elucidated as predictive factors for undergoing TKA among patients with RA.
本研究旨在阐明类风湿关节炎（RA）患者中全膝关节置换术（TKA）的患病率及预测因素。
分析了2003年纳入日本全国队列数据库NinJa并连续随访至2009年的1134例RA患者的数据。
在观察期内，76例患者接受了TKA。接受TKA的患者在2003年至2004年期间改良健康评估问卷（mHAQ）评分的年度进展显著高于未接受TKA的患者，而28个关节疾病活动评分（DAS28）或患者视觉模拟量表（VAS）评分的年度进展则无显著差异。多因素分析显示，疾病累及膝关节、高Steinbrocker分期（III或IV期）以及入组时患者高VAS评分是有力的预测因素，风险比分别为4.01、3.71和1.20。以TKA为终点的生存分析显示，入组时疾病累及膝关节的患者5年生存率显著低于未累及膝关节的患者（分别为83.5%和97.0%）。
阐明了RA患者中接受TKA的几个预测因素。
