Acute Periprosthetic Infection After Total Knee Arthroplasty in Patients With Rheumatoid Arthritis Versus Osteoarthritis: a Population-based Study

Abstract Osteoarthritis is the main cause for total knee arthroplasty, followed by rheumatoid arthritis. Previous studies have reported conflicting results concerning the risk of periprosthetic infection after total knee arthroplasty for rheumatoid arthritis and osteoarthritis patients. Thus, this study aimed to examine whether rheumatoid arthritis patients had a higher risk of acute periprosthetic infection after total knee arthroplasty compared to osteoarthritis patients. We conducted a retrospective cohort study using Taiwan’s National Health Insurance Research Database of the whole population from 2012 to 2015, and collected the medical records of osteoarthritis patients or rheumatoid arthritis patients who underwent total knee arthroplasty. To evaluate the risk of acute periprosthetic infection in rheumatoid arthritis patients, propensity score matching was implemented for osteoarthritis patients. Acute periprosthetic infection was observed in 2.58% of total knee arthroplasty cases in rheumatoid arthritis patients and 2.66% of total knee arthroplasty cases in osteoarthritis patients. Rheumatoid arthritis and osteoarthritis patients had comparable risk for 90-day and one-year periprosthetic infection. In conclusion, patients with rheumatoid arthritis were not at higher risk of acute periprosthetic infection after total knee arthroplasty compared to osteoarthritis patients. The current treatment strategy for patients with rheumatoid arthritis undergoing total knee arthroplasty is safe and appropriate.