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The cruciate ligaments in knee replacement
F W Hagena1, G O Hofmann, T Mittlmeier
1Staatliche Orthopädische Klinik München, Federal Republic of Germany.
International Orthopaedics
|January 1, 1989
Summary
Cruciate ligaments in rheumatoid arthritis knees show significantly reduced tensile strength and altered biomechanical properties compared to osteoarthritis knees. This suggests total knee replacement is beneficial for severe rheumatoid knee damage.
Area of Science:
- Orthopedic Surgery
- Rheumatology
- Biomedical Engineering
Background:
- Severe rheumatoid arthritis (RA) and osteoarthritis (OA) can cause significant knee joint damage.
- Ligament integrity is crucial for knee joint stability and function.
Purpose of the Study:
- To histologically and biomechanically compare cruciate ligaments from patients with severe RA or OA to healthy controls.
- To evaluate the impact of RA and OA on ligament properties relevant to total knee arthroplasty (TKA).
Main Methods:
- Resection of cruciate ligaments with bony insertions during TKA in 12 RA/OA patients.
- Histological and biomechanical examination of resected ligaments.
- Comparison with ten ligament specimens from healthy adults.
Main Results:
- Significant differences in tensile stiffness and viscoelastic properties were observed between arthritic and control ligaments.
- Ligaments from rheumatoid knees exhibited markedly inferior tensile strength compared to osteoarthritic knees.
- Degenerative changes in arthritic ligaments impact their structural integrity.
Conclusions:
- Rheumatoid arthritis severely compromises cruciate ligament tensile strength and biomechanical function.
- Osteoarthritis also affects ligament properties, but to a lesser extent than RA.
- Total knee replacement, which restores ligament function, should be strongly considered for severely damaged rheumatoid knees.