Cementless Total Knee Arthroplasty with Posterior Cruciate Retention in Rheumatoid Arthritis

ABSTRACT

PURPOSE: The result of cementless total knee arthroplasty with posterior cruciate ligament retention in rheumatoid arthritis patients was evaluated. MATERIALS AND METHODS: Thirty patients (fifty knees) followed up after cementless total knee arthroplasty with posterior cruciate ligament retention was evaluated clinically and radiologically. Average follow up was 9.2 years(5.1~14.3). RESULTS: The mean HSS knee score improved from 47.4 preoperatively to 81.8 postoperatively, and the mean range of motion of 89.7 degrees preoperatively to 101.2 degrees postoperatively. The mean tibiofemoral angle was 4.9 degrees valgus. Posterior instability was observed in 1 case(2%) at the most recent follow up. Radiolucent line was observed in 41 cases(82%), and osteolysis was observed around tibial component in 13 cases(26%), and around femoral component in 4 cases(8%). Eight cases(16%) of revision was due to 1 case of aseptic loosening and osteolysis each, and the other due to polyethylene wear of patellar or tibial component. CONCLUSION: Although there are osteopenia in rheumatoid arthritis compared to osteoarthritis, cementless total knee replacement with posterior cruciate retention showed stable fixation. However, the new method for initial fixation of tibial component is needed because osteolysis around tibial component tended to start around cancellous screws.