If you have arthritis, there may come a time when the cartilage around a specific joint — often the knee or hip — has degenerated so much that the best course of action is to opt for joint replacement surgery. Surgery always comes with some risks, but the extent of those risks varies based on a number of factors, including your underlying health conditions.
Many people who end up getting joint replacement surgery have some type of arthritis. Both osteoarthritis (OA) and inflammatory arthritis like rheumatoid arthritis (RA) can lead to serious joint damage, but these two conditions are quite different. The biggest distinction is that OA is a “wear-and-tear” form of the disease that happens as a result of damage to a joint over a long period of time. RA, in contrast, is an autoimmune disease in which your immune system mistakenly attacks previously healthy tissue, including in and around the joints.
To compare how people with RA and OA fare after joint replacement surgery, Danish researchers analyzed data from three large rheumatology registries. They ended up homing in on 2,899 RA patients and 112,571 OA patients who had joint replacement surgery between the years 2000 and 2014.
According to their findings, which were published in the journal Seminars in Arthritis and Rheumatism, RA patients who undergo hip or knee replacement were more apt to develop infections within three months of surgery that were not specific to the incision site. Those included pneumonia, sepsis, and a bacterial skin infection called erysipelas. However, RA patients who had knee replacement were less likely than those with OA who had the same procedure to develop a venous thromboembolism (VTE), a dangerous type of blood clot.
“The lower risk of VTE following total knee [reconstruction] is intriguing given that RA is a well-established risk factor for VTE in a nonsurgical setting,” the authors wrote.
One possible explanation is that OA patients are more apt to be obese, and obesity is a risk factor for blood clots. OA patients are also more likely to use NSAID medication (such as ibuprofen), which has also been associated with an increased risk of clots.