Comparison of reconstructive orthopaedic surgery in patients with seropositive and seronegative rheumatoid arthritis.

The longitudinal orthopaedic history of 107 unselected patients with rheumatoid arthritis undergoing reconstructive surgery was studied to define the relationship between serology and surgery. Using strict criteria 85 patients were seropositive and 22 seronegative. Age, disease duration, number of reconstructive orthopaedic operations, and second-line or corticosteroid drug treatment were similar in seropositive and seronegative patients. Users of steroids and/or second-line drugs had a similar number of operations to non-users. However, patients undergoing only hip or knee surgery used steroids more often in the pre-operative disease than those only having other operations (p less than 0.05). This may reflect more-aggressive disease or the direct effect of steroids. The expected proportions of seropositive and seronegative patients together with their similar surgical and treatment patterns do not suggest that they have different diseases.