Background/Purpose: The aim of this study was to investigate the impact of total joint arthroplasty (TJA) on the disease activity and functional measures of young patients with rheumatoid arthritis (RA).

Methods: Totally 15341 RA patients were registered with NinJa (National Database of Rheumatic Diseases by iR-net in Japan）, which is one of the biggest database of nation-wide observational cohort in JAPAN. The data including HAQ-DI (Health Assessment Questionnaire Disability Index), EQ-5D (EuroQol 5 Dimension) as well as SDAI（Simplified disease activity index）, CDAI (Clinical Disease Activity Index) and DAS28 (Disease Activity Score 28) was analyzed.

Results: Among them, 1960 patients were under 50 years old, 85 with TJA (group T) and 1875 without TJA (group C). The age at onset of RA was 25.1 years old in group T and 33.5 years old in group C. Methotrexate was used in 54 patients (63.5%) in group T and in 1333 patients (71.5%) in group C, and biologics was used in 49 patients (57.6%) in group T and in 639 patients (34.1%) in group C. In group T, HAQ-DI was 0.97, EQ-5D was 0.68, DAS28 was 2.98，SDAI was 9.06，and CDAI was 8.59. Each score was inferior to that in group C (0.27，0.81，2.51，6.17，5.78, respectively). Moreover, in comparison with 11126 patients over 50 years old without TJA (group O), each score in group T was also inferior to that of group O (0.55，0.77，2.90，6.82，6.28, respectively).

Conclusion: The data demonstrated that patients of group T showed higher disease activity and lower functional ability as well as lower QOL status despite functional reconstruction with TJA, suggesting that the more aggressive therapeutic strategy should be needed for better functional outcome in young patients undergoing TJA.

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ACR Meeting Abstracts - https://acrabstracts.org/abstract/analysis-of-the-disease-activity-and-functional-measures-of-young-patients-with-rheumatoid-arthritis-undergoing-total-joint-arthroplasty-by-using-the-database-of-nation-wide-observational-cohort/