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Full flexion after total knee replacement in rheumatoid arthritis
S Yoshino1, H Shoji, M Komagamine
1Department of Joint Diseases, Nippon Medical School, Tokyo, Japan.
International Orthopaedics
|January 1, 1990
Summary
Total knee replacement using the Y-S prosthesis yielded good range of motion in rheumatoid arthritis patients. Postoperative rehabilitation and specific implant features contributed to successful outcomes, including the ability to squat fully.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Biomedical Engineering
Background:
- Rheumatoid arthritis frequently necessitates total knee replacement (TKR) due to joint destruction.
- Assessing functional outcomes and range of motion (ROM) is crucial for TKR success in rheumatoid arthritis (RA) patients.
Observation:
- The Y-S total knee prosthesis was evaluated in 152 patients (227 knees) with rheumatoid arthritis.
- Follow-up ranged from 2 to 4 years, with an average of 2.7 years.
- Key surgical techniques included calibrated distractor use for soft tissue balancing and a flattened tibial plateau prosthesis.
Findings:
- Good range of motion was generally achieved, with 14 patients (27 knees) regaining the ability to squat fully.
- Preoperative range of motion positively correlated with postoperative range of motion.
- Outcomes and ROM did not significantly differ between rheumatoid arthritis and osteoarthritis patients.
- Knees with full flexion showed no significant differences in stability or radiographic findings compared to those with limited flexion.
Implications:
- The Y-S prosthesis, combined with meticulous surgical technique and rehabilitation, can restore significant function in RA patients.
- Preoperative ROM is a valuable predictor of postoperative functional recovery.
- The findings support the efficacy of this TKR approach for inflammatory arthritis and degenerative joint disease.