Multiple Joint Arthroplasties of the Lower Extremity in Rheumatoid Arthritis

Between 1978 and 1995, 98 total hip arthroplasties (THA) and 142 total knee arthroplasties (TKA) were carried out in 152 patients with rheumatoid arthritis (RA). Multiple joint arthroplasties (three or more joints) were performed on 30 THAs and 31 TKAs in 17 patients with RA. The mean age was 51.4 years at the first operation and 56.4 years at the final surgery. The mean interval between each surgery was 4.5 years.Of the 16 rheumatoid patients, 11 improved to independent ambulation, 2 deteriorated to limited ability, one was confined to a wheelchair and 2 had died. General complications were found in 8 patients (14.1%), but they did not influence the patient's life span. There were a few local complications (28%) resulting from the total 57 arthroplastic procedures and 11 joints required reoperation.Surgical therapy plays an important part in management of RA once joint destruction has occurred, and therefore arthroplasty must be considered as soon as possible.