Average 10.1-year follow-up of cementless total knee arthroplasty in patients with rheumatoid arthritis

Abstract

Background: Total knee arthroplasty (TKA) using a cemented technique has been recommended in patients with rheumatoid arthritis owing to the initial stability of the fixation and long-term durability of the components; however, similar long-term follow-up results have been reported in patients who have undergone cementless TKA. The purpose of this study was to evaluate the radiologic and clinical outcomes of cementless TKA in patients with rheumatoid arthritis. Methods:We enrolled patients undergoing cementless TKA from March 1990 to February 2000. Clinical and radiologic evaluations were performed using the Knee Society clinical rating system and radiographic evaluation and scoring system. Results:We included the cases of 112 patients who underwent 179 cementless TKA procedures in our analysis. Their mean age was 62.3 years, and the mean follow-up period was 10.1 years. The final survival rate was 0.968 at the 15.5-year follow-up. Regarding radiologic results after surgery, the mean total valgus angle was 6.7°, the mean femoral flexion angle was 97.5° and the mean tibial angle was 89.2° on the anteroposterior radiographs. On the lateral films, the mean femoral flexion angle was 1.6° and the mean tibial angle was 89.2°. At the last follow-up, the mean total valgus angle was 6.5°, the mean femoral flexion angle was 97.4° and the mean tibial angle was 89.1°, as seen on the anteroposterior view. On the lateral views, the mean femoral flexion angle was 1.4° and the mean tibial angle was 89.0°. Regarding the clinical outcome, the mean knee score and function score on the Knee Society clinical rating system were also enhanced from 47.5 and 43.6, respectively, before the operation to 91.2 and 82.3, respectively, at the last follow-up. Conclusion:On radiologic and clinical follow-up of cementless TKA for patients with rheumatoid arthritis, there were no serious complications, and the results of the operation were satisfactory with improvement in range of motion and clinical symptoms.Contexte : On a recommandé l'arthroplastie totale du genou (ATG) fixée par ciment orthopédique chez les patients souffrant de polyarthrite rhumatoïde, en raison de la stabilité initiale de la fixation et de la longue durabilité des composantes. Or, des résultats similaires ont été enregistrés au suivi à long terme chez des patients qui ont subi une ATG non cimentée. Cette étude avait pour but d'évaluer l'issue radiologique et clinique de l'ATG non cimentée chez des patients souffrant de polyarthrite rhumatoïde.

Cementless total knee arthroplasty

“…Eskola et al 74 studied 42 patients with rheumatoid arthritis, and although there was one revision due to ligamentous laxity and two patients had radiolucencies of more than 2 mm, the authors found no clinically-evident loosening in cementless knees in this group of patients. Woo et al 75 reported 179 rheumatoid arthritic knees with a mean follow-up of 10.1 years and estimated the 15.5 year survivorship of this fully cementless TKA group to be 96.8%.…”

Modern Trends in Orthopedics: The Knee Arthroplasty

“…При анализе исходов лечения 112 больных рев-матоидным артритом, которым было выполне-но 179 артропластик с минимальным периодом наблюдения 10,1 лет, 15-летняя выживаемость бесцементных имплантатов, по данным Y.K. Woo с соавторами, составила 96,8% [63].…”

Cementless Total Knee Arthroplasty in Patients Older Than 75 Years

“…25,26 Recently, studies have reported increased longevity and improved implant fixation and bone stock with the emergence of newer biomaterials and implant designs. 25,[27][28][29][30][31][32] Cementless fixation depends on bone apposition to the implant's surface, and the biologic fixation between the bone and metal may result in improved longterm results. 26,27 However, there have been concerns regarding the bony fixation in elderly patients, 15,33 which may be due to decreased bone remodeling that occurs with normal aging.…”