Total knee arthroplasty in Paget's disease: technical problems and results

Area of Science:

• Orthopedic Surgery
• Rheumatology
• Bone Metabolism Disorders

Background:

• Paget's disease of bone can affect joints, potentially leading to arthritis and the need for joint replacement surgery.
• Total knee arthroplasty (TKA) is a common procedure for end-stage arthritis, but its outcomes in patients with metabolic bone diseases like Paget's require specific evaluation.

Purpose of the Study:

• To evaluate the long-term outcomes of cemented total knee arthroplasties in patients diagnosed with Paget's disease.
• To assess component fixation, functional improvement, and patient-reported outcomes following TKA in this patient cohort.

Main Methods:

• A retrospective review of eleven total knee arthroplasties performed in ten patients with Paget's disease.
• Analysis of postoperative range of motion, Knee Society scores, radiographic evidence of component fixation, and complications.

Main Results:

• Average follow-up was 2 to 16 years postoperatively.
• Significant improvement in range of motion (21 degrees) and an average Knee Society score of 83 points.
• All components on pagetic bone demonstrated solid radiographic interfaces at an average of 5.7 years; only one loose component was identified.

Conclusions:

• Cemented total knee arthroplasty can achieve good long-term functional outcomes in patients with Paget's disease.
• Despite potential surgical challenges related to Paget's disease, stable component fixation and patient improvement are achievable.
• This study supports TKA as a viable option for managing knee arthritis in patients with Paget's disease.