Summary. Knee joint injury in patients with rheumatoid arthritis (RA) occurs in 70% of cases. This is the most common cause of loss of work capacity and the ability to selfcare; patients become severely disabled, since the disease is accompanied by contractures with the development of discordant positions of the lower limbs, which leads to a partial or complete loss of the function of support and walking. Thus, this problem needs to be studied.
Objective: to analyze the orthopedic treatment of secondary arthrosis of the knee joints in patients with RA, complicated by contractures.
Materials and Methods. In this study, we have analyzed the orthopedic treatment of 66 RA patients with secondary arthrosis with contractures, who underwent 75 total knee replacements between 2013 and 2020. Anamnestic data, clinical, biomechanical and statistical research methods were used.
Results. The analysis of the results of total knee replacement was followed in the period from 6 months to 5 years. The results were evaluated according to the 100-point scale by J. Joseph,
E.E. Kaufman (1550). The majority of patients had good treatment results.
Conclusions. Total knee replacement is required in patients with 2nd phase of the stage II of the disease and higher. In our opinion, this is the most optimal time for surgical treatment, which allows patients with RA to fully use the capabilities of an implanted endoprosthesis.
Haiko HV. State of arthroplasty in Ukraine and prospects for its development. Totalne i reviziine endoprotezuvannia velykykh suhlobiv. 2003:3-7. (in Ukrainian)
Canovas F, Dagneaux L. Quality of life after total knee arthroplasty. Orthop Traumatol. Surg. Research. 2018;(104):41-6.
Ozawa J, Kaneguchi A, Minamimoto K, Tanaka R, Kito N, Moriyama H. Accumulation of advanced-glycation end products (AGEs) accelerates arthrogenic joint contracture in immobilized rat knee. Journal of Orthopaedic Research. 2017;36(3):854-863.
Lee JK, Choi CH. Total knee arthroplasty in rheumatoid arthritis. Knee Surg Relat Res. 2012;24(1):1-6. doi: 10.5792/ksrr.2012.24.1.1.
Babko AM, Herasymenko AS. The Mechanism of Contracture Formation in the Hip and Knee Joints in Early Stages of Rheumatoid Arthritis (Natural Experiment). Visnyk ortopedii, travmatolohii ta protezuvannia. 2019;(4):57-65. doi: http://orcid.org/0000- 0001-591.
Yamashita F, Funakoshi N, Mori D, Kizaki K. Long-term outcomes and duration of outdoor ambulation following primary total knee arthroplasty in patients with rheumatoid arthritis. Journal of Orthopaedic Science. 2021. doi: 10.1016/j.jos.2021.01.014.
Kerner PJ, Clarke HD, Scuderi GR. Total knee arthroplasty for rheumatoid arthritis. Modern Rheumatology 2003;13(4):289-92. doi: 10.3109/s10165-003-0255-4.
Khatri K, Bansal D, Rajpal K. Management of Flexion Contracture in Total Knee Arthroplasty. Knee Surgery Reconstruction and Replacement. 2020. doi: 10.5772/intechopen.90417.
da Silva E, Doran MF, Crowson CS, O'Fallon WM, Matteson EL. Declining use of orthopedic surgery in patients with rheumatoid arthritis. Results of a long-term, population-based assessment. Arthritis Rheum. 2003;49(2):216-20. doi: 10.1002/art.10998.
Danoff JR, Moss G, Liabaud B, Geller JA. Total knee arthroplasty considerations in rheumatoid arthritis. Autoimmune Dis. 2013;2013:1-6. doi: 10.1155/2013/185340.
Eid AS, Nassar WA, Fayyad TA. Total knee replacement with tibial tubercle osteotomy in rheumatoid patients with stiff knee. Int Orthop. 2016;40(11):2289-2293. doi: 10.1007/s00264-0163167-6.
Sohail MZ, Aresti N, Hanna SA, Malik AA, Khan WS. The Perioperative Management of the Rheumatoid Patient Undergoing Total Knee Arthroplasty: A Review of Literature. Curr Rheumatol Rev. 2015;11(1):34-38. doi: 10.2174/15733971116661505220953 21.
Herasymenko SI. Orthopedic treatment of rheumatoid arthritis with lesions of the lower extremities. Presa Ukrainy. 2000:160.
Lombardi Jr AV, Mallory TH, Adams JB, Herrington SM. A stepwise algorithmic approach to flexion contractures in total knee arthroplasty. Arch Am Acad Orthop Surg. 1997;1:1-8.
Jaffe WL, Dundon JM, Camus T. Alignment and Balance Methods in Total Knee Arthroplasty. Journal of the American Academy of Orthopaedic Surgeons 2018;26(20):709-16. doi: 10.5435/ JAAOS-D-16-00428.
This work is licensed under a Creative Commons Attribution 4.0 International License.