Impact of orthopaedic surgery on quality of life in patients with rheumatoid arthritis: a retrospective study using the FRANK (Fukuoka rheumatoid arthritis Network) registry.

OBJECTIVES

To clarify the impact of orthopaedic surgery on the quality of life (QOL) in patients with rheumatoid arthritis (RA), by comparing surgical cases with matched non-surgical controls using multicenter data from the Fukuoka Rheumatoid Arthritis NetworK (FRANK) registry.

METHODS

A retrospective cohort study was conducted using FRANK registry data (2018-2022). Sixty-three surgical cases and non-surgical controls were analysed after propensity score matching for age, sex, disease duration, disease activity, and medication. Changes in disease activity (DAS28-ESR), activities of daily living (modified health assessment questionnaire), and QOL (EuroQol 5-Dimensional Questionnaire, EQ-5D) over 1 year were compared using paired and independent t-tests. Regression analyses identified predictors of QOL improvement.

RESULTS

The majority of patients were in low disease activity (DAS28-ESR < 3.2). The surgical group showed a statistically significant improvement in EQ-5D (+0.04; P < 0.05), while no change was observed in the non-surgical group. Lower preoperative EQ-5D was the predictor of improvement. Mobility and anxiety/depression domains contributed most to QOL gains.

CONCLUSIONS

Orthopaedic surgery significantly improves QOL in RA patients, even in those with a low DAS-ESR28. Patients with lower baseline QOL benefit most. These findings support the importance of surgical intervention as a complementary strategy in holistic RA management.