Problems involved in total knee arthroplasty for rheumatoid arthritis patients

In view of the systemic nature of rheumatoid arthritis, total knee arthroplasty in these patients should be preceded by a careful evaluation of general and local clinical status in terms of systemic changes and pathological changes in the adjacent hip and foot joints. In the event of destructive changes in these joints, a change in the sequence of operations should be considered. All the components of joint deformity should be corrected during surgery. The surgical outcome depends not only on the operative technique, the proper selection of prosthesis, and postoperative rehabilitation, but also on the progression of the disease and the state of advancement of pathological changes in other joints. After surgery, the parameters of general physical capacity (such as walking distance, stair climbing and descending, standing up and sitting down) are difficult to evaluate. The outcome of arthroplasty should be evaluated primarily in terms of pain relief and function in the operated joint.