Lifetime Risk for Hip, Knee Replacement Doubles After RA Diagnosis

The lifetime risk for knee and hip replacement for individuals with a diagnosis of RA is approximately double that of the general population, according to a UK study.

The lifetime risk of undergoing surgery for hip and knee replacement after a diagnosis of rheumatoid arthritis (RA) is about double compared with that of the general population, according to a study published in Rheumatology.

Researchers retrospectively analyzed patient data (n=13,961) from the English National Health Service, which includes patient records and demographics for a subset of the UK population. Various clinical and demographic information was collected including age, body mass index, smoking status, and the Charlson comorbidity score. Subsequently, the team merged several 15-year parametric survival models and extrapolated the results to approximate lifetime risk.

Related Articles

After analysis, the researchers found that the lifetime risk of undergoing surgery for hip and knee replacement was 17% (95% CI, 11%-26) and 22% (95% CI, 16%-29), respectively, after a diagnosis of RA for the average patient. In addition, they reported that risks were greater for younger individuals, but did not vary based on sex, smoking status, or socioeconomic status.

One key limitation of the study was the lack of private sector data.

“The lifetime risks of knee and hip replacement for 50-year-olds from the general UK population has previously been estimated respectively as 11 and 12% for women and 8 and 7% for men,” the researchers wrote.

“These findings allow for a better understanding of long-term prognosis and healthcare resource use, and highlight the importance of timely diagnosis and effective treatment,” they concluded.

Disclosure: Multiple authors disclosed affiliations with pharmaceutical companies. See the reference for complete disclosure information.


Burn E, Edwards CJ, Murray DW, et al. Lifetime risk of knee and hip replacement following a diagnosis of RA: findings from a cohort of 13 961 patients from England [published online April 23, 2019]. Rheumatology. doi:10.1093/rheumatology/kez143