Clinical Outcomes of Methotrexate Usage in Postoperative Arthroplasty Patients: An Evidence Based Review
Bibliographic record
Abstract
Patient dissatisfaction after joint arthroplasty remains common. Synovitis is known to contribute to patient dissatisfaction in patients with osteoarthritis. Methotrexate (MTX) is commonly used to prevent joint deterioration in rheumatoid arthritis, however it is much less common in the treatment of osteoarthritic patients. This review explores the effect of MTX on surgical outcomes in the general arthroplasty patient population. While most of the papers reviewed include patients with rheumatoid arthritis, we also review papers that include patients with osteoarthritis and juvenile idiopathic arthritis. Publications were queried in PUBMED and OVID MEDLINE using the following terms: arthroplasty, joint replacement, methotrexate, DMARDs, osteoarthritis, rheumatoid arthritis, arthritis. After applying exclusion criteria, we identified 12 publications for this review. Our results showed no significant increase in revisions or long-term infections were reported in patients taking MTX. One study reported detriment to nerve function with postoperative MTX use. All other studies reported no difference in post-operative pain or function scores. One study investigating the effect of MTX on mobility in rheumatoid arthritis patients following arthroplasty showed improvement in function in patients taking MTX. Thus, based on this review, perioperative MTX use does not appear to worsen arthroplasty outcomes. This review should suffice as a building block for further investigations and trials into MTX's utility for arthroplasty patients.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.017 | 0.031 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.009 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".