ArticleClinical rheumatology2026
Long-term knee function and disease activity outcomes of total knee arthroplasty in patients with rheumatoid arthritis: a retrospective study with an average 10-year follow-up.
Article in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveThis study aimed to evaluate the effects of total knee arthroplasty (TKA) for rheumatoid arthritis (RA) on both knee function and disease activity with an average 10-year follow-up period.
methodsThis retrospective study reviewed 61 RA patients who underwent primary TKA with a mean follow-up of 10.2 years (5 to 15 years). Clinical outcomes included knee function, assessed using the Knee Society Score (KSS), and RA disease activity, evaluated with the 28-Joint Disease Activity Score using C-reactive protein (DAS28-CRP) and the Clinical Disease Activity Index (CDAI). Medication use, including methotrexate, prednisolone, and biologic DMARDs, was also analyzed.
resultsTKA significantly improved knee function, with mean KSS knee and function scores increasing from 41.05 and 44.59 preoperatively to 84.26 (p < 0.05) and 71.92 (p < 0.05), respectively, at final follow-up. RA disease activity also improved, since DAS28-CRP decreased from 3.90 to 2.42 (p < 0.05), and CDAI decreased from 18.96 to 7.76 (p < 0.05) at final follow-up. Patients treated with biologic DMARDs had superior KSS function scores compared with those on non-biologic DMARDs at postoperative 5 years (p < 0.05) and final follow-up (p < 0.05).
conclusionsTKA provides sustained improvements in knee function and reduces RA disease activity over the long term, highlighting its dual benefits for joint and systemic health. Combining TKA with biologic DMARDs may optimize outcomes, offering a comprehensive therapeutic approach for RA patients with severe knee involvement. Key Points • Total knee arthroplasty (TKA) in rheumatoid arthritis provides sustained improvement in knee function over an average 10-year follow-up. • TKA also contributes to long-term reductions in systemic disease activity, demonstrating benefits beyond joint-level outcomes. • Patients receiving biologic DMARDs achieve superior functional outcomes, supporting the value of combining surgical and advanced pharmacological therapies.
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