Knee prosthesis in rheumatoid patients

Total knee arthroplasty is a reliable means to improve the quality of life not only in osteoarthritis, but also in rheumatoid patients. Specific aspects, like the low mechanical quality of bone tissue, the contemporary damage of several joints and the higher risk of complications, have to be taken into account in rheumatoid arthritis. The experience with 24 prostheses in 21 rheumatoid patients is reported and confirms the efficacy of this operation. Among the technical details discussed, stress is placed on the conservation of the posterior cruciate ligament, the use of cement, the procedure of patelloplasty instead of prosthetic replacement. Careful preoperative planning is required and resections, especially in the tibia, should be economical. The evaluation of the results according to the protocol of the America Knee Society shows a satisfactory increase both of the articular score (average from 36 to 88) and the functional score (average from 34 to 68).