Geometric total knee replacement for treatment of the rheumatoid knee

The results of fifty-four geometric total knee arthroplasties in forty-four patients with definite or classic rheumatoid arthritis were analyzed twenty-four to sixty-four months after the surgical procedure. There were no operative deaths, no postoperative infections, and no known pulmonary emboli. Three patients required additional operative procedures on the knee: one, a patellectomy for pain one year after arthroplasty; the second, resection of tibial bone and reinsertion of the tibial component to correct a flexion contracture; and the third, replacement of the tibial component because of loosening. The relief of pain and increase in ability to carry out the activities of daily living were dramatic in these patients, who, because of the limitations imposed by their rheumatoid arthritis, applied minimum stress on the prosthetic knees. Postoperatively, the average arc of knee flexion was 104 degrees.