The Journal of Bone and Joint Surgery, Vol 70, Issue 1 84-87, Copyright © 1988 by Journal of Bone and Joint Surgery, Inc
Total knee arthroplasty in young adults who have rheumatoid arthritis
MJ Stuart and JA Rand
Department of Orthopaedics, Mayo Clinic, Rochester, Minnesota 55905.
At the Mayo Clinic, between 1978 and 1982, forty-four total knee
arthroplasties were performed with cement in twenty-six adults who had
rheumatoid arthritis. The age at operation ranged from nineteen to
thirty-nine years old. The twenty-six patients were followed for two to
eight years (average, five years). At the time of final follow-up,
thirty-nine knees were free of pain and five were mildly painful during
weight-bearing. The Hospital for Special Surgery knee score improved from a
mean of 52 points preoperatively to 84 points postoperatively. There were
twenty-four excellent, fourteen good, six fair, and no poor results.
Radiographic analysis revealed an incomplete radiolucent line that was more
than one millimeter in width adjacent to five tibial and four femoral
components in eight knees (18 per cent). The positions of the components
had not changed. Postoperatively, there was one transient peroneal palsy
and two knees required patellar resurfacing. No revisions were performed
for loosening of a prosthesis. We concluded that use of a cemented total
knee prosthesis in a patient who has rheumatoid arthritis and is less than
forty years old provides a satisfactory result and that the component will
not loosen after an average of five years.
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