Clinical Edge

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Post-Operative Flares in RA After Total Hip & Knee Arthroplasty

In patients with rheumatoid arthritis (RA), higher disease activity increased risk of worse pain and function 1 year after arthroplasty, but post-operative flares did not. This according to a recent study that evaluated RA flares after total hip (THA) and total knee arthroplasty (TKA). RA patients were enrolled before THA/TKA. Patients Reported Outcomes (PROS) including Hip and Knee Osteoarthritis/disability and injury Outcomes Scores (HOOS/KOOS) and MD evaluations of disease characteristics and activity were collected before surgery. PROS were repeated at 1 year. Researchers found:

  • 1-year HOOS/KOOS scores were available for 122 patients.
  • HOOS/KOOS pain was worse for patients who flared within 6 weeks of surgery.
  • In multivariable models, baseline DAS28 predicted 1-year HOOS/KOOS pain and function.
  • Post-operative flares were not independent risk factors for pain or function scores.


Goodman SM, et al. Rheumatoid arthritis flares after total hip and total knew arthroplasty: Outcomes after 1 year. [Published online ahead of print October 14, 2019]. Arthritis Care Res. doi: 10.1002/acr.24091.