Cementless Total Knee Arthroplasty and Effects of Disease Modifying Anti-Rheumatic Drugs in Rheumatoid Arthritis / 대한정형외과학회잡지

PURPOSE: We reviewed patients with rheumatoid arthritis to evaluate the results of cementless total knee replacement and the effects of Disease Modifying Anti-Rheumatoid Drugs. MATERIALS AND METHODS: The results of 59 cementless total knee arthroplasty in 35 patients were retrospectively analyzed. Cases were divided into two groups: one was treated with Disease Modifying Anti-Rheumatic Drugs and the other without them. Clinical and radiological outcomes were evaluated using the Knee Society clinical rating system and Knee Society roentgenographic evaluation and scoring system, respectively. RESULTS: At the most recent follow-up, femoral flexion angle, tibial angle and total valgus angle in anteroposterior view were 97.1, 89.1 and was 7.6. Femoral flexion angle and tibial angle in lateral view were 3.0 and 91.0. There were no statistical differences as compared with the postoperative values. There were also no statistical differences between the two groups. Knee score and function score of all cases were 85.5 and 67.6. Those of the group treated with Disease Modifying Anti-Rheumatic Drugs were 90.9 and 78.1. Those of the group without them were 74.0 and 45.5. CONCLUSIONS: Results of the cementless total knee arthroplasty in rheumatoid arthritis are very promising and Disease Modifying Anti-Rheumatic Drugs have an effect on the postoperative clinical results.

Cementless Total Knee Arthroplasty in Rheumatoid Arthritis / 대한정형외과학회잡지

We evaluated the clinical and radiologic results of 48 cases (31 patients) who had rheumatoid arthritis of the knee joint and were managed with cementless total knee arthroplasty between November 1988 and December 1994. The mean follow-up period was 3.7 years (range, 2 to 7 years). The knee score of the Hospital for Special Surgery improved from an average of 44 points (range, 5 to 77 points) preoperatively to 83 points (range, 50 to 97 points) at the time of the most recent followup examination. In knee score, 85.4% of cases had excellent or good grade (over 75 points). The range of motion improved from an average of 77 degrees to an average of 103 degrees postoperatively. In tibiofemoral angle, 95.8% of cases were between valgus I degree and 10 degrees. The implants were inserted in an optimal position. Continuous radiolucency was not visible beneath any implant and loosening was not found. In one case, heterotopic ossification was removed to improve the range of motion. There was one case of patellar fracture during operation. Even in relatively poor bone quality in rheumatoid arthritis of the knee, the cementless total knee arthroplasty revealed good clinical and radiologic results.