Lupus & antiphospholipid syndrome
Joint surgery rates in lupus: a long-term cohort study
Authors' conclusion
The overall burden of joint surgery in SLE is high and despite a reduction in avascular necrosis, arthroplasty and arthrodesis rates have not decreased over time.
Study context
- Population
- Patients with SLE and propensity-matched controls, state-wide Hospital Morbidity Data Collection, 1985–2015
- Exposure
- SLE vs propensity-matched controls
- SLEn = 1,855
- Rhupusn = 120
- Controlsn = 12,840reference
- Outcome
- Joint procedures (arthroplasty, arthrodesis or synovectomy): ORs and incidence rates (IRs) per 100 person-years
Methodological detailspropensity-matched controls, state-wide Hospital Morbidity Data Collection, regression analysis
- Propensity-matched controls
- State-wide Hospital Morbidity Data Collection
- Regression analysis
Main finding
As reported in the abstract
Any joint procedure
Each group vs controlsEstimate (CI)
SLE
OR 10.8(8.86–13.24)
SLE
rate ratio 19.9(16.83–23.55)
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | |
|---|---|---|
| Arthroplasty, arthrodesis and synovectomy in rhupus (highest odds among SLE)Rhupusvs Controls | OR (arthroplasty) 4.49 (CI 2.87–6.92) | |
| Arthroplasty, arthrodesis and synovectomy in rhupus (highest odds among SLE)Rhupusvs Controls | OR (arthrodesis) 6.64 (CI 3.28–12.97) | |
| Arthroplasty, arthrodesis and synovectomy in rhupus (highest odds among SLE)Rhupusvs Controls | OR (synovectomy) 9.02 (CI 4.32–18.23) | |
| 0.050.21520Ratio (log scale) |
- Arthroplasty, arthrodesis and synovectomy in rhupus (highest odds among SLE): rhupus n=120, 60.5%
IR of overall joint procedures in rhupus over time · three study decades
- IR unchanged (8.7 to 8.6), R2=0.004
- P = 0.98
IR of avascular necrosis underlying arthroplasty, all SLE, over time · three study decades
- IR decreased (0.52 to 0.10)
- P = 0.02
Joint procedures in other SLE vs controls
- Other SLE had significantly higher OR and IR for all three joint procedures than controls; insignificant decreases in synovectomy and increases in arthroplasty over time
Original publication
Joint surgery rates in lupus: a long-term cohort study. Lupus Sci Med. Published 10 January 2024. doi:10.
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