Total knee arthroplasty in patients with rheumatoid arthritis – midterm results
Abstract
Background/Aim. Total knee arthroplasty in patients with rheumatoid arthritis is an effective method of eliminating pain and improving functional status, but it is associated with a number of unique challenges. The aim of this study was to evaluate the clinical and radiographic outcomes of total knee arthroplasty, as well as patient satisfaction, in this series of patients with rheumatoid arthritis. Methods. Between January 2001 and 2012, 108 total knee arthroplasties in 78 patients with rheumatoid arthritis were performed, utilizing a posterior-stabilized prostheses. The average age of the patients was 58 ± 12.4 years, and 88% were females. Median follow-up of patients was 80 months with interquartile range of 34 months (min-max: 36-132 months). Results. Average Knee Society score improved from preoperative 18 ± 11.4 to postoperative 83 ± 3.5, and Functional Knee Society score from 21 ± 9.9 to 50 ± 5.9. Western Ontario and McMaster Universities Arthritis (WOMAC) knee injury and osteopaedic outcome scores improved from 23 ± 6.4 to 69 ± 4.6 postoperatively. In 25 (23.14%) knees radiolucent lines of less than 2 mm were found and they were not progressive. Survival rate excluding deep infection was 99.1%. Conclusion. Total knee arthroplasty is an effective procedure of treatment of damaged knee joint in patients with rheumatoid arthritis.
References
Lee JK, Choe CH. Total knee arthroplasty in rheumatoid arthri-tis. Knee Surg Relat Res 2012; 24(1): 1−6.
Danoff JR, Moss G, Liabaud B, Geller JA. Total knee arthroplasty considerations in rheumatoid arthritis. Autoimmune Dis 2 013; 2013: 185340.
Yamanaka H, Goto K, Suzuki M. Clinical results of Hi-tech Knee II total knee arthroplasty in patients with rheumatoid athritis: 5- to 12-year follow-up. J Orthop Surg Res 2012; 7: 9.
Insall JN, Dorr LD, Scott RD, Scott WN. Rationale of the Knee Society clinical rating system. Clin Orthop Relat Res 1989; (248): 13−4.
Bellamy N, Wilson C, Hendrikz J, Whitehouse SL, Patel B, Dennison S, et al. Osteoarthritis Index delivered by mobile phone (m-WOMAC) is valid, reliable, and responsive. J Clin Epidemiol 2011; 64(2):182−90.
Schrama JC, Espehaug B, Hallan G, Engesaeter LB, Furnes O, Have-lin LI, et al. Risk of revision for infection in primary total hip and knee arthroplasty in patients with rheumatoid arthritis compared with osteoarthritis: a prospective, population-based study on 108,786 hip and knee joint arthroplasties from the Norwegian Arthroplasty Register. Arthritis Care Res (Hobo-ken). 2010; 62(4): 473−9.
Dusad A, Pedro S, Mikuls TR, Hartman CW, Garvin KL, O'dell JR, et al. Impact of Total Knee Arthroplasty as Assessed Using Patient-Reported Pain and Health-Related Quality of Life In-dices: Rheumatoid Arthritis Versus Osteoarthritis. Arthritis Rheumatol 2015; 67(9): 2503−11.
Singh JA, Lewallen DG. Better functional and similar pain out-comes in osteoarthritis compared to rheumatoid arthritis after primary total knee arthroplasty: a cohort study. Arthritis Care Res (Hoboken) 2013; 65(12): 1936−41.
Scott CE, Bugler KE, Clement ND, MacDonald D, Howie CR, Biant LC. Patient expectations of arthroplasty of the hip and knee. J Bone Joint Surg Br 2012; 94(7): 974−81.
Bourne RB, Chesworth BM, Davis AM, Mahomed NN, Charron KD. Patient satisfaction after total knee arthroplasty: Who is satis-fied and who is not. Clin Orthop Relat Res 2010; 468(1): 57−63.
Clement ND, Burnett R. Patient satisfaction after total knee arth-roplasty is affected by their general physical well-being. Knee Surg Sports Traumatol Arthrosc 2013; 21(11): 2638−46.
Wylde V, Learmonth I, Potter A, Bettinson K, Lingard E. Patient-reported outcomes after fixed- versus mobile-bearing total knee replacement: A multi-centre randomised controlled trial using the Kinemax total knee replacement. J Bone Joint Surg Br 2008; 90(9): 1172−9.
Keenan AC, Wood AM, Arthur CA, Jenkins PJ, Brenkel IJ, Walmsley PJ. Ten-year survival of cemented total knee replacement in patients aged less than 55 years. J Bone Joint Surg Br 2012; 94(7): 928−31.
Saleh KJ, Kurdi AJ, El-Othmani MM, Voss BA, Tzeng TH, Saleh J, et al. Perioperative Treatment of Patients with Rheumatoid Arthritis. J Am Acad Orthop Surg 2015; 23(9): e38−48.
Bongartz T, Halligan CS, Osmon DR, Reinalda MS, Bamlet WR, Crowson CS, et al. Incidence and risk factors of prosthetic joint infection after total hip or knee replacement in patients with rheumatoid arthritis. Arthritis Rheum 2008; 59(12): 1713−20.
da Cunha BM, de Oliveira SB, Santos-Neto L. Incidence of infec-tious complications in hip and knee arthroplasties in rheuma-toid arthritis and osteoarthritis patients. Rev Bras Reumatol 2011; 51(6): 609−15. (English, Portuguese)
Boonen A, Severens JL. The burden of illness of rheumatoid arthritis. Clin Rheumatol 2011; 30 Suppl 1: S3−8.
Kang JH, Hsieh MS, Lin HC. Comparison of treatment out-comes following total knee arthroplasty among patients with rheumatoid arthritis and osteoarthritis: a nationwide popula-tion-based study. Rheumatology (Oxford) 2010; 49(7): 1409−10.
Kapetanovic MC, Lindqvist E, Simonsson M, Geborek P, Saxne T, Eberhardt K. Prevalence and predictive factors of comorbidity in rheumatoid arthritis patients monitored prospectively from disease onset up to 20 years: Lack of association between in-flammation and cardiovascular disease. Scand J Rheumatol 2010; 39(5): 353−9.
Sivakumar B, Akhavani MA, Winlove CP, Taylor PC, Paleolog EM, Kang N. Synovial hypoxia as a cause of tendon rupture in rheumatoid arthritis. J Hand Surg Am 2008; 33(1): 49−58.
Matsumoto H, Okuno M, Nakamura T, Yamamoto K, Osaki M, Hagino H. Incidence and risk factors for falling in patients after total knee arthroplasty compared to healthy elderly individuals. Yonago Acta Med 2014; 57(4): 137–45.