Abstract
Objectives
Biologic agents (BIO) drastically changed the rheumatoid arthritis (RA) therapy from starting to use biologics at 2003 in Japan. The rate of orthopaedic surgery, especially total joint arthroplasty (TJA) may reflect trends in disease severity, management and health outcomes.
Methods
We surveyed the number and rate of orthopaedic surgeries and TJA in RA treatment with BIO in the last decade, so called BIO-era.
Results
We had 18,701 cases of orthopaedic surgeries, including 491 rheumatoid surgeries from 2004 to 2013. They contained 382 cases of total joint arthroplasties (78%), including 258 total knee arthroplasty (TKA), 80 total hip arthroplasty (THA), 18 total elbow arthroplasty (TEA), 14 total ankle arthroplasty (TAA), 4 swanson arthroplasty for fingers. The numbers of orthopaedic surgery increased year by year. The rate of rheumatoid surgeries not changed in the last decade (r=0.8, p<0.05, Fig. 1). The numbers of TSA and TEA in 2009–2013 increased twice compared to them in 2004–2008, but TKA and THA not changed. We had 241 RA patients treated by biologics agents from 2003, including 60 rheumatoid surgeries with the biologic therapy. Over half of rheumatoid surgeries were TJA (37 cases; 61%), including 26 cases for lower joint; 11 cases for upper joint. The rate of upper TJA more increased than that of lower joint in the RA patients with BIO in this decade.
Conclusion
TJA for upper joint that improve the quality of life may increase in the RA patients with biologic therapy, because their disease activity and attitudes have changed year by year in this BIO-era.
