抄録
Postoperative results of total knee arthroplasty were assessed clinically and radiologically. Kinematic anteriorly joint type total knee arthroplasty was carried out on 47 knees of 30 rheumatoid patients. Patella resurfacing was not performed on 42 knees. The mean age of patients at time of surgery was 54.3 years (range, 30-75 years) and the mean follow-up period was 7 years (range, 5-11 years) . Clinical results were assessed using the Criteria for Evaluating Rheumatoid Arthritis of the Knee of the Japanese Orthopaedic Association. The average score was 37.9±9.4 before surgery, which improved to 67.3±16.1 at follow-up. Pain in the patello-femoral joints was found in 16 knees (34%), all of which except one had no patella resurfacing. Radiographic findings revealed that of the cases without patella resurfacing, these was a tendency of patella subluxation as well as patella infra (lateral shift of the patella was 13.9 ±5.2 mm, lateral tilt of the patella was 14.4 ± 4.9°and Insall-Salvati's ratio was 0.84 ±0.17) . There was no significant correlation between the radiographic deterioration and severity of pain in the patello-femoral joints. These results suggest that patella resurfacing should be performed in TKA for rheumatoid patients.
