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Outcomes 'better than expected' for lupus patients undergoing joint replacement

Published on 15 November 2012
Outcomes 'better than expected' for lupus patients undergoing joint replacement

People with lupus who undergo joint replacement surgery face a lower risk of adverse events and benefit more from the procedure than previously thought, scientists have found.

Researchers at the Hospital for Special Surgery in New York analysed data on 101 lupus patients who had a knee or hip replaced at the hospital since 2007, as well as age-matched patients with osteoarthritis.

They found that two years after surgery, levels of pain and function were similar for patients with lupus and those with osteoarthritis.

This is despite the fact that patients with lupus typically had much worse pain and function before undergoing surgery than osteoarthritis patients.

The study, which was presented at the annual meeting of the American College of Rheumatology, also revealed that lupus patients who underwent knee replacement surgery rarely did so because of osteonecrosis (bone death caused by poor blood supply).

This was a surprising finding, as it was assumed that joint replacement surgery in these individuals was usually carried out because of osteonecrosis caused by their use of steroids.

In fact, while many lupus patients who had a hip replaced did indeed have osteonecrosis, the condition was present in hardly any of those who had a knee replaced.

Lead researcher Dr Susan Goodman, a rheumatologist at the Hospital for Special Surgery, said: "Before this study, our assumption was that lupus patients underwent arthroplasty for osteonecrosis at least half of the time and that they don't do as well.

"We now know that they do very well in terms of pain and function outcomes and that the knee patients are very unlikely to have osteonecrosis. They resembled their age-matched control peer group."

Dr Lisa Mandl, who was also involved in the study, added that lupus patients tend to be in a worse condition before having joint replacement surgery, but actually do "almost as well as the osteoarthritis patients" following the operation.

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