{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T00:55:31Z","timestamp":1792803331318,"version":"4.5.0"},"reference-count":37,"publisher":"The Journal of Rheumatology","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>Rates of total knee arthroplasty (TKA) and total hip arthroplasty (THA) remain high for patients with rheumatoid arthritis (RA), who are at risk of flaring after surgery. We aimed to describe rates, characteristics, and risk factors of RA flare within 6 weeks of THA and TKA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>Patients with RA were recruited prior to elective THA and TKA surgery and prospectively followed. Clinicians evaluated RA clinical characteristics 0\u20132 weeks before and 6 weeks after surgery. Patients answered questions regarding disease activity including self-reported joint counts and flare status weekly for 6 weeks. Per standard of care, biologics were stopped before surgery, while glucocorticoids and methotrexate (MTX) were typically continued. Multivariable logistic regression was used to identify baseline characteristics associated with postsurgical RA flares.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>Of 120 patients, the mean age was 62 years and the median RA duration 14.8 years. Ninety-eight (82%) met 2010\/1987 American College of Rheumatology\/European League Against Rheumatism criteria, 53 (44%) underwent THA (and the rest TKA), and 61 (51%) were taking biologics. By 6 weeks, 75 (63%) had flared. At baseline, flarers had significantly higher disease activity (as measured by the 28-joint Disease Activity Score), erythrocyte sedimentation rate, C-reactive protein, and pain. Numerically more flarers used biologics, but stopping biologics did not predict flares, and continuing MTX was not protective. A higher baseline disease activity predicted flaring by 6 weeks (OR 2.12, p = 0.02).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>Flares are frequent in patients with RA undergoing arthroplasty. Higher baseline disease activity significantly increases the risk. Although more patients stopping biologics flared, this did not independently predict flaring. The effect of early postsurgery flares requires further study.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.170366","type":"journal-article","created":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T11:35:16Z","timestamp":1521113716000},"page":"604-611","source":"Crossref","is-referenced-by-count":56,"title":["Flares in Patients with Rheumatoid Arthritis after Total Hip and Total Knee Arthroplasty: Rates, Characteristics, and Risk Factors"],"prefix":"10.3899","volume":"45","author":[{"given":"Susan M.","family":"Goodman","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian P.","family":"Bykerk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"DiCarlo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ryan W.","family":"Cummings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura T.","family":"Donlin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dana E.","family":"Orange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Hoang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Serene","family":"Mirza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"McNamara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayte","family":"Andersen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan J.","family":"Bartlett","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jackie","family":"Szymonifka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark P.","family":"Figgie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2018,3,15]]},"reference":[{"key":"2018112909383028000_45.5.604.1","doi-asserted-by":"publisher","DOI":"10.1016\/j.semarthrit.2013.01.002"},{"key":"2018112909383028000_45.5.604.2","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22596"},{"key":"2018112909383028000_45.5.604.3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2011-200387"},{"key":"2018112909383028000_45.5.604.4","first-page":"234","article-title":"Improved health-related quality of life with effective disease-modifying antirheumatic drugs: evidence from randomized controlled trials","volume":"14","author":"Strand","year":"2008","journal-title":"Am J Manag Care"},{"key":"2018112909383028000_45.5.604.5","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.141251"},{"key":"2018112909383028000_45.5.604.6","doi-asserted-by":"crossref","first-page":"254","DOI":"10.1002\/art.38231","article-title":"Increased risk of complications following total joint arthroplasty in patients with rheumatoid arthritis","volume":"66","author":"Ravi","year":"2014","journal-title":"Arthritis Rheumatol"},{"key":"2018112909383028000_45.5.604.7","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.140011"},{"key":"2018112909383028000_45.5.604.8","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kev364"},{"key":"2018112909383028000_45.5.604.9","doi-asserted-by":"publisher","DOI":"10.1002\/art.23721"},{"key":"2018112909383028000_45.5.604.10","first-page":"2828","article-title":"2017 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":"39","author":"Goodman","year":"2017","journal-title":"Arthritis Rheumatol"},{"key":"2018112909383028000_45.5.604.11","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2015-000225"},{"key":"2018112909383028000_45.5.604.12","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.131252"},{"key":"2018112909383028000_45.5.604.13","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2014.07.014"},{"key":"2018112909383028000_45.5.604.14","doi-asserted-by":"publisher","DOI":"10.1136\/ard.2006.054205"},{"key":"2018112909383028000_45.5.604.15","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20621"},{"key":"2018112909383028000_45.5.604.16","doi-asserted-by":"publisher","DOI":"10.1002\/art.1780380612"},{"key":"2018112909383028000_45.5.604.17","first-page":"841","article-title":"Validity and reproducibility of self-administered joint counts. 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