COMPARISON OF THE RESULTS OF BILATERAL TOTAL KNEE ARTHROPLASTY WITH AND WITHOUT PATELLAR REPLACEMENT FOR RHEUMATOID-ARTHRITIS - A FOLLOW-UPNOTE

Simultaneous bilateral total knee arthroplasty was performed in twenty -six patients who had rheumatoid arthritis, and a patellas replacement was performed concurrently in one randomly selected knee in each pati ent, A lateral retinacular release was performed in all knees, The pat ients were followed for at least six years (mean, 6.6 years; range, 6. 0 to 7.5 years), and the postoperative status of the patients was eval uated with the knee score of The Hospital for Special Surgery, Pain on standing and on ascending or descending stairs as well as tenderness of the patello-femoral joint also were assessed. The over-all score an d the individual stores for pain, function, range of motion, muscle st rength, flexion contracture, and instability were not significantly di fferent between the knees that had had a patellar replacement and thos e that had not, However, pain on standing and on ascending or descendi ng stairs as well as tenderness of the patellofemoral joint mere only noted in knees that had not had a patellar replacement, These findings suggest that, in order to diminish pain on standing and on using stai rs, replacement of the patella during total knee arthroplasty is prefe rable for patients who have rheumatoid arthritis.