Rheumatoid Arthritis

The hip joint is one of the synovial joints and destruction can occur in RA patients. Once hip destruction appears in RA, it progresses rapidly, and the patient’s daily activities are markedly impaired. THA is an excellent surgical procedure for RA hip disorders, with good clinical results and long-term durability. THA for RA has been found to be almost as durable as OA. In a comparison of revision rates due to aseptic loosening between cemented and cementless THA in RA, there is no difference in the stems, although there are reports of lower revision rates for cementless cups. Complications of THA in RA include periarticular fractures, postoperative dislocation, and infection. In particular, the dislocation rate is reported to be approximately twice as high as that of OA. Regarding perioperative drug management, MTX withdrawal is not necessary, but biological agents and JAK inhibitors should be withdrawn for a certain period of time before surgery.