Total knee arthroplasty in juvenile arthritis

Sixteen patients with 29 knee arthroplasties due to juvenile arthritis were studied. Eight patients had been wheelchair-bound and were nonambulatory due to hip and knee involvement. Surgery was indicated for correction of deformity, decreased range of motion, and relief of pain. The average preoperative disability score was 40.3, and postoperative score was 79.9. Thirteen of the 16 patients also required bilateral hip replacement arthroplasty. The average hospital stay for bilateral knee arthroplasty under one anesthesia was 45.3 days. The average followup was 36 months with a range of 24 months to 7 years. The overall results were excellent in 13 knees, good in 11, fair in 3, and poor in 2. Ambulation improved in all but 2 of the knees. Of the 2 failures, 1 was due to deep infection and the other to severity of disease and poor cooperation of the patient, who remains wheelchair-bound.