Background: Surgical treatment of patients with rheumatoid arthritis (RA) is associated with an increased risk of complications. This is due to the presence of an inflammatory process, a variety of variants of the course of the disease, reduced physical activity, the severity of functional disorders, prolonged therapy with glucocorticoids, disease-modifying and genetically engineered biological drugs, osteoporosis, as well as the activity of the underlying disease.

Objectives: to conduct a comparative analysis of the effect of RA treatment on local complications, such as periprosthetic infection, periprosthetic fractures, wound complications, ligamentous disorders in hip and knee total arthroplasty in patients with RA.

Methods: 1113 arthroplasties of large joints in patients with RA, which were performed in the period from 2002 to 2020, were analyzed. Of these, 649 total knee replacements (TKA) and 464 total hip replacements (THA) were performed.

Results: In patients with therapy of methotrexate at an average dose of 12.5 mg per week, the incidence of local complications was 7.87%. In patients receiving Leflunomide (Arava), complications were detected in 9.29% of cases. In group of patients with Sulfasalazine (SSZ) intake, local complications were detected in 7.73% of cases. The complication rate of 7.01% was determined in group of patients who received Glucocorticoids (GC) at an average dose of 7.5 mg (recalculation in Prednisone). 1.87% of complications were observed in patients with intake of genetically engineered biological drugs (bDMARD). The highest incidence of local complications was found in patients with RA who had no therapy (27.27%).

Statistical data analysis revealed a significantly higher number of complications in the group of RA patients (p<0.005). Analyzing each type of complications, significant differences were also obtained (p<0.005).

Conclusion: The risk of local complications was 3 or more times higher in group of patients with RA without any treatment. So, arthroplasties of large joints in patients with RA without treatment are often accompanied by a high risk of intra- and postoperative complications.

Disclosure of Interests: None declared