Total knee arthroplasty for the treatment of bilateral knee rheumatoid arthritis in the same period

Chen Rong-bo; Hou Na; Wang Ren; He Ming; Wang Er-feng; Zhang Wei-tao; Li Xiao-jian; Li Xian-zhi

doi:10.3969/j.issn.2095-4344

Abstract：BACKGROUND:Total knee arthroplasty is the major treatment of rheumatoid arthritis at advanced stage. Most of scholars prefer the staging replacement and adopt semi-restricting prosthesis to increase the stability of prosthesis. <br> OBJECTIVE:To investigate the clinical effect of synchronous total knee arthroplasty for treatment of bilateral knee rheumatoid arthritis. <br> METHODS:From June 2011 to December 2013, 27 patients of knee rheumatoid arthritis were recruited from the First Department of Orthopedics at the Third Hospital of Chinese PLA, and were treated with total knee arthroplasty at the bilateral sides over the same period. According to the symptoms, functional recovery and imaging evaluation, postoperative effect was assessed. The involved patients were folowed up at 2 weeks, 1 month, 3 months, 6 months after surgery and afterwards once per year. The relief of pain symptoms, recovery of joint function, X-ray examination, loosening and sink of the prosthesis were observed during folow-ups. <br> RESULTS AND CONCLUSION:Al the patients were folowed up over a period of 9-26 months. After operation the pain disappeared, preoperative flexion and varus valgus deformity were corrected, limb walking function recovered wel. The Hospital for Special Surgery scores was average 31.8 points before operation and increased to average 82.7 points after operation. There was no infection, lower limb deep vein thrombosis, loosening and sink of the prosthesis. Simultaneous total knee arthroplasty at the bilateral sides is a safe, effective operation method in the treatment of bilateral knee rheumatoid arthritis, with short recovery time and hospitalization period, it can avoid psychological and economic impact of the two single knee replacement operations to the patients.