Abstract
We reviewed 15 total knee arthroplasties for rheumatoid arthritis (RA) patients from 1994 to 2002. The subjects were 2 men (2 knees) and 9 women (13 knees). The mean age at the operation was 66.1 years (60-74 years). The average follow-up period was 2.6 years (3 months-6.3 years). RA activity was well controled in the all patients. All of the defects were at the medial tibial plateau. The Deltafit 7000 implant was used in 14 knees and the Nexgen flex implant, 1 knee.
For the bone defect, bone cement for 8 knees, 10°metal wedge for 2 knees, 20°metal wedge for 3 knees, metal block with hydroxyapatite for 1 knee, and autograft for 1 knee were used respectively. The average point score of the Japanese Orthopaedic Association (JOA) scoring system for RA knees improved from 39.0 to 87.5. All types of augmentations worked well. In conclusion, in TKA for RA patients, we used metal wedge, metal block and autograft respectively according to the volume of bone defect, and could obtain good results. In cases with massive bone defect, it might be necessary to use combination of various augmentations, because single method was not enough to cover the defect.
