{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T04:53:14Z","timestamp":1760244794373,"version":"build-2065373602"},"reference-count":39,"publisher":"MDPI AG","issue":"24","license":[{"start":{"date-parts":[[2022,12,15]],"date-time":"2022-12-15T00:00:00Z","timestamp":1671062400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81972046","2022-PUMCH-B-001"],"award-info":[{"award-number":["81972046","2022-PUMCH-B-001"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National High Level Hospital Clinical Research Funding","award":["81972046","2022-PUMCH-B-001"],"award-info":[{"award-number":["81972046","2022-PUMCH-B-001"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: The number of patients with primary Sj\u00f6gren\u2019s syndrome (pSS) who require total knee arthroplasty (TKA) is expected to increase, and there are few studies describing their outcomes. This research was focused on the evaluation of a TKA cohort in pSS patients and to compare outcomes with those of matched individuals from the general population. Methods: From 2004 to 2020, we found 36 TKAs in 30 patients with pSS from the single-institution arthroplasty registry, and they were matched for age, gender, bilateral or unilateral surgery, American Society of Anesthesiologists (ASA) score, and year of surgery with 72 TKAs in 60 osteoarthritis patients without rheumatic diseases (1:2 ratio). Perioperative outcomes were obtained, and clinical evaluations were performed at the last follow-up. Results: After a mean six-year follow-up, both cohorts had similar knee function and health-related quality of life outcomes. The pSS group had more patients with post-operative anemia and hypoalbuminemia and more patients needing platelet transfusion. There were no significant differences in other complications, the rates of 90-day readmission, or overall revision. By multivariate analysis, the influencing factor for anemia in pSS patients was lower preoperative hemoglobin (OR = 0.334, 95% CI (0.125\u20130.889), p &lt; 0.05). Conclusions: Our study demonstrated that pSS patients who received TKA could achieve comparable clinical outcomes to the general population. However, more attention should be paid to the perioperative hematological management of pSS patients who underwent TKA.<\/jats:p>","DOI":"10.3390\/jcm11247438","type":"journal-article","created":{"date-parts":[[2022,12,16]],"date-time":"2022-12-16T02:54:02Z","timestamp":1671159242000},"page":"7438","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Total Knee Arthroplasty in Patients with Primary Sj\u00f6gren\u2019s Syndrome: A Retrospective Case-Control Study Matched Patients without Rheumatic Diseases"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5188-3435","authenticated-orcid":false,"given":"Songlin","family":"Li","sequence":"first","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, West China Hospital, Sichuan University, Chengdu 610017, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ruichen","family":"Ma","sequence":"additional","affiliation":[{"name":"School of Medicine, Tsinghua University, Beijing 100190, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shanni","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongjun","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jin","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xisheng","family":"Weng","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wenwei","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Orthopedic Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100006, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,12,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1056\/NEJMcp1702514","article-title":"Primary sjogren\u2019s syndrome","volume":"378","author":"Mariette","year":"2018","journal-title":"N. Engl. J. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e3821","DOI":"10.1136\/bmj.e3821","article-title":"Primary sjogren syndrome","volume":"344","author":"Bosch","year":"2012","journal-title":"BMJ"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1093\/rheumatology\/keq420","article-title":"Diagnostic significance of measuring antibodies to cyclic type 3 muscarinic acetylcholine receptor peptides in primary sjogren\u2019s syndrome","volume":"50","author":"He","year":"2011","journal-title":"Rheumatology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"609","DOI":"10.1093\/rheumatology\/32.7.609","article-title":"The arthropathy of sjogren\u2019s syndrome","volume":"32","author":"Pease","year":"1993","journal-title":"Br. J. Rheumatol."},{"key":"ref_5","first-page":"640265","article-title":"Joint involvement in primary sjogren\u2019s syndrome: An ultrasound \u201ctarget area approach to arthritis\u201d","volume":"2013","author":"Hofmann","year":"2013","journal-title":"Biomed. Res. Int."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"452","DOI":"10.1016\/j.ultrasmedbio.2018.09.024","article-title":"Comparative assessment of hand joint ultrasound findings in symptomatic patients with systemic lupus erythematosus and sjogren\u2019s syndrome: A pilot study","volume":"45","author":"Lei","year":"2019","journal-title":"Ultrasound Med. Biol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1797","DOI":"10.1016\/j.joca.2017.07.022","article-title":"Projected increase in total knee arthroplasty in the united states\u2014an alternative projection model","volume":"25","author":"Inacio","year":"2017","journal-title":"Osteoarthr. Cartil."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1455","DOI":"10.2106\/JBJS.17.01617","article-title":"Projected volume of primary total joint arthroplasty in the u.s., 2014 to 2030","volume":"100","author":"Sloan","year":"2018","journal-title":"J. Bone Joint Surg. Am."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1111\/os.12933","article-title":"Medium-term clinical results of high-flexion knee prostheses in patients with rheumatoid arthritis","volume":"13","author":"Xu","year":"2021","journal-title":"Orthop. Surg."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.arth.2018.11.003","article-title":"Rheumatoid arthritis patients achieve better satisfaction but lower functional activities as compared to osteoarthritis patients after total knee arthroplasty","volume":"34","author":"Kobayashi","year":"2019","journal-title":"J. Arthroplast."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"655","DOI":"10.1016\/j.arth.2015.09.049","article-title":"Midterm outcomes following total knee arthroplasty in lupus patients","volume":"31","author":"Issa","year":"2016","journal-title":"J. Arthroplast."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1002\/acr.24893","article-title":"2022 American college of rheumatology\/American association of hip and knee surgeons guideline for the perioperative management of antirheumatic medication in patients with rheumatic diseases undergoing elective total hip or total knee arthroplasty","volume":"74","author":"Goodman","year":"2022","journal-title":"Arthritis Rheumatol."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Singh, J.A., and Cleveland, J.D. (2020). Sjogren\u2019s syndrome is associated with higher rate of non-home discharge after primary hip arthroplasty and higher transfusion rates after primary hip or knee arthroplasty: A u.s. Cohort study. BMC Musculoskelet. Disord., 21.","DOI":"10.1186\/s12891-020-03514-9"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1136\/ard.61.6.554","article-title":"Classification criteria for sjogren\u2019s syndrome: A revised version of the european criteria proposed by the american-european consensus group","volume":"61","author":"Vitali","year":"2002","journal-title":"Ann. Rheum. Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1136\/annrheumdis-2016-210571","article-title":"2016 american college of rheumatology\/european league against rheumatism classification criteria for primary sjogren\u2019s syndrome: A consensus and data-driven methodology involving three international patient cohorts","volume":"76","author":"Shiboski","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"968","DOI":"10.1136\/ard.2010.143743","article-title":"Eular sjogren\u2019s syndrome patient reported index (esspri): Development of a consensus patient index for primary sjogren\u2019s syndrome","volume":"70","author":"Seror","year":"2011","journal-title":"Ann. Rheum. Dis."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"453","DOI":"10.1002\/1529-0131(200110)45:5<453::AID-ART365>3.0.CO;2-W","article-title":"The western ontario and mcmaster universities osteoarthritis index (womac): A review of its utility and measurement properties","volume":"45","author":"Mcconnell","year":"2001","journal-title":"Arthritis Care Res."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"9939891","DOI":"10.1155\/2022\/9939891","article-title":"The efficacy of pulsed electromagnetic fields on pain, stiffness, and physical function in osteoarthritis: A systematic review and meta-analysis","volume":"2022","author":"Tong","year":"2022","journal-title":"Pain Res. Manag."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/j.knee.2021.01.009","article-title":"Forgotten joint score: Comparison between total and unicondylar knee arthroplasty","volume":"29","author":"Gill","year":"2021","journal-title":"Knee"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1016\/j.jval.2021.03.009","article-title":"Mapping eq-5d-3l to eq-5d-5l","volume":"24","author":"Shaw","year":"2021","journal-title":"Value Health"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"283","DOI":"10.1007\/s40271-020-00452-5","article-title":"How do respondents interpret and view the eq-vas? A qualitative study of three asian populations","volume":"14","author":"Tan","year":"2021","journal-title":"Patient"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"2148","DOI":"10.1097\/CORR.0000000000000378","article-title":"Intravenous tranexamic acid reduces postoperative blood loss after high tibial osteotomy","volume":"476","author":"Palanisamy","year":"2018","journal-title":"Clin. Orthop. Relat. Res."},{"key":"ref_23","first-page":"224","article-title":"Prediction of blood volume in normal human adults","volume":"51","author":"Nadler","year":"1962","journal-title":"Surgery"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1097\/00005792-200207000-00003","article-title":"Primary sjogren syndrome: Clinical and immunologic disease patterns in a cohort of 400 patients","volume":"81","author":"Rosas","year":"2002","journal-title":"Medicine"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e66","DOI":"10.1136\/rmdopen-2015-000066","article-title":"Acpa-positive primary sjogren\u2019s syndrome: True primary or rheumatoid arthritis-associated sjogren\u2019s syndrome?","volume":"1","author":"Payet","year":"2015","journal-title":"RMD Open"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1937","DOI":"10.3899\/jrheum.080234","article-title":"Association of severe inflammatory polyarthritis in primary sjogren\u2019s syndrome: Clinical, serologic, and hla analysis","volume":"36","author":"Mohammed","year":"2009","journal-title":"J. Rheumatol."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1443","DOI":"10.1007\/s00296-012-2572-4","article-title":"Follow-up of primary sjogren\u2019s syndrome patients presenting positive anti-cyclic citrullinated peptides antibody","volume":"33","author":"Ryu","year":"2013","journal-title":"Rheumatol. Int."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1007\/s10067-005-1104-y","article-title":"Anti-ccp and antikeratin antibodies in rheumatoid arthritis, primary sjogren\u2019s syndrome, and wegener\u2019s granulomatosis","volume":"24","author":"Kamali","year":"2005","journal-title":"Clin. Rheumatol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"911","DOI":"10.1002\/acr.21610","article-title":"Primary sjogren\u2019s syndrome as a systemic disease: A study of participants enrolled in an international sjogren\u2019s syndrome registry","volume":"64","author":"Malladi","year":"2012","journal-title":"Arthritis. Care Res."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"284","DOI":"10.1097\/MD.0b013e3181b76ab5","article-title":"Hematologic manifestations and predictors of lymphoma development in primary sjogren syndrome: Clinical and pathophysiologic aspects","volume":"88","author":"Baimpa","year":"2009","journal-title":"Medicine"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1097\/00005792-200207000-00004","article-title":"Primary sjogren syndrome: Hematologic patterns of disease expression","volume":"81","author":"Font","year":"2002","journal-title":"Medicine"},{"key":"ref_32","doi-asserted-by":"crossref","unstructured":"National Kidney Foundation Anemia Working Group (2001). Nkf-k\/doqi clinical practice guidelines for anemia of chronic kidney disease: Update 2000. Am. J. Kidney Dis., 37, S182\u2013S238.","DOI":"10.1016\/S0272-6386(01)70008-X"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1007\/s00296-003-0323-2","article-title":"Anemia, serum vitamin b12, and folic acid in patients with rheumatoid arthritis, psoriatic arthritis, and systemic lupus erythematosus","volume":"24","author":"Segal","year":"2004","journal-title":"Rheumatol. Int."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2367","DOI":"10.1016\/j.arth.2020.04.029","article-title":"Tranexamic acid does not reduce the risk of transfusion in rheumatoid arthritis patients undergoing total joint arthroplasty","volume":"35","author":"Morse","year":"2020","journal-title":"J. Arthroplast."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1056","DOI":"10.1213\/ane.0b013e318164f114","article-title":"Postoperative anemia and quality of life after primary hip arthroplasty in patients over 65 years old","volume":"106","author":"Conlon","year":"2008","journal-title":"Anesth. Analg."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1097\/00005131-200407000-00007","article-title":"The effect of perioperative anemia on clinical and functional outcomes in patients with hip fracture","volume":"18","author":"Halm","year":"2004","journal-title":"J. Orthop. Trauma"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"234","DOI":"10.1002\/anr.1780320222","article-title":"Thrombocytopenia in patients with sjogren\u2019s syndrome","volume":"32","author":"Sugai","year":"1989","journal-title":"Arthritis Rheum."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"889","DOI":"10.2106\/JBJS.19.00511","article-title":"Low preoperative albumin levels predict adverse outcomes after total joint arthroplasty","volume":"102","author":"Kishawi","year":"2020","journal-title":"J. Bone Joint Surg. Am."},{"key":"ref_39","first-page":"985","article-title":"Management of skin necrosis around incision following total knee arthroplasty","volume":"28","author":"Shen","year":"2014","journal-title":"Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/24\/7438\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:41:58Z","timestamp":1760146918000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/11\/24\/7438"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,15]]},"references-count":39,"journal-issue":{"issue":"24","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["jcm11247438"],"URL":"https:\/\/doi.org\/10.3390\/jcm11247438","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2022,12,15]]}}}