Outcome from multiple joint replacement surgery to the lower limbs.

All patients who had three or more major joints (hips or knees) replaced were identified from operation records at one hospital and reviewed to assess outcome. Forty-three were found to suffer from rheumatoid arthritis, four from osteoarthritis and three from psoriatic arthritis. Eight patients had died an average of 2.6 years (range 1-7 years) after their last operation and this was higher than expected, even for RA. Average follow-up in the 36 surviving RA sufferers was 1.8 years, with a minimum of 6 months since last operation. Range of joint movement, pain relief, satisfaction, mobility, disability and social outcomes were assessed and are reported. Patients were satisfied with outcome because of pain relief and functional improvement. No patient required permanent in-patient care, although they still represented a very disabled group with mean HAQ score of 2.75.