Biological Agent and Total Hip Arthroplasty in Rheumatoid Arthritis.

Purpose: Therapies for treatment of rheumatoid arthritis (RA) have shown significant improvement since the introduction of biological agents (BIO) in 2003 and Janus kinase inhibitors (JAKi) in 2013 in Japan. The rate of orthopedic surgery, including total hip arthroplasties (THA), may reflect trends in disease severity, management, and health outcomes.

Materials and methods: An analysis of data on THAs performed at our institutes for treatment of RA with BIO or non-BIO therapy from 2004 to 2021 was conducted.

Results: A total of 40,328 orthopedic surgeries, including 5,938 primary THAs and 204 RA-THAs, were performed between 2004 and 2021. An increase in the annual rate of THA performed for patients undergoing orthopedic surgery was observed. The rates of THA decreased annually for patients with RA when compared to the total number of orthopedic surgeries and primary THAs performed.

Conclusion: The number of THAs performed for patients with RA may show an annual decrease resulting from early and aggressive drug therapy for management of RA in the era of BIO and JAKi. However, patients with RA undergoing THA have several unmet needs, including secondary osteoarthritis, dislocation, periprosthetic joint infection, and periprosthetic fracture with osteoporosis.