抄録
We report the long-term results of total knee arthroplasty (TKA) with a kinematic stabilizer performed on patients with chronic rheumatoid arthritis (RA) between October 1984 and June 1989. The procedure was performed on 50 patients (71 joints), of whom 15 (21 joints) died. We analyzed the results of the 31 patients (45 joints) who could be surveyed. Six were men and 25 were women. The mean age at the time of surgery was 56.4 years (range, 40-77 years) . The patients were followed up for a mean period of 9 years and 10 months. Walking ability of class 3 was maintained in 77.4% of patients, and the mean JOA score was 75.9. Arhhroplasty was revised in 6 patients (6 joints) (8.4%) . Slight inversion of the tibial component and flexion of the femoral component were seen in many cases, and the tibial component hung posteriorly in many cases. The clear zone was 10% on the femoral side and 17.5% on the tibial side, and was 2 mm or less in all cases. TKA for RA is therefore considered very worthwhile. However, surgery is of limited use in patients with generalized progressive RA which is unresponsive to the various forms of drug therapy since it is difficult to maintain the walking ability over a long term, no matter how accurately surgery is performed. Surgery is advisable even in young RA patients if the pain and impairment of activities of daily life are severe.
