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MR Vol.14 No.1 indexに戻る
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MODERN RHEUMATOLOGY
Vol.14 No.1 |
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HLA-DRB1 haplotype did not affect the medium-term
results of total knee arthroplasty in patients with rheumatoid arthritis
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| Seisuke Takemura1 , Yoshitaka Toda2, JOrg J.
Goronzy3, Cornelia M. Weyand3, Ryokei Ogawa1 and Hirokazu Iida1 |
(1) Department of Orthopaedic Surgery, Kansai
Medical University, 10-15 Fumizono-machi, Moriguchi, 570-8506,
Japan
(2) Toda Orthopedic and Rheumatology Clinic, Suita, Japan
(3) Department of Medicine, Mayo Clinic, Rochester, MN, USA
(4) Present address: Department of Orthopaedic Surgery, Yamatotakada Municipal
Hospital, 1-1 Isonokitamachi, Yamatotakada, 635-0094, Japan |
Received: 14 March 2003 Accepted: 07 August 2003 |
| Abstract |
| Abstract This study investigated whether the
HLA-DRB1 susceptible allele (SA) genotype is predictive for total
knee arthroplasty (TKA) failure in patients with rheumatoid arthritis
(RA). The results of 49 TKAs (30 RA patients) with an average follow-up
of 7.9 years (range 5?15 years) were analyzed using a 12-item questionnaire
and the Knee Society system. HLA-DRB1 alleles were used to estimate
the severity of RA and divide the patients into three categories
depending upon the gene dose of SA (SA+/+, SA+/?, and SA?/?). For
all three categories, the 12-item questionnaire had significantly
improved postoperatively, but without significant difference. We
divided the 12 items of the questionnaire into two groups: knee-relevant
parameters and general parameters. Patients in all three groups improved
similarly in knee-relevant parameters. In contrast, those homozygous
for SA (SA+/+) benefited less in general parameters. The average
radiolucency score was 1.87mm, with no difference being detected
among the three groups. The HLA-DRB1 genotype did not affect the
survival of the knee implants. Overall, patients without the RA-associated
HLA gene benefited most from TKA as they improved not only in knee
function, but also in parameters of general functional status. |
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| Key words |
| Key words Disease severity - Human leukocyte
antigen (HLA) - Rheumatoid arthritis (RA) - Susceptible allele (SA)
- Total knee
arthroplasty (TKA) |
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