Total knee arthroplasty in patients with rheumatoid arthritis presents seve
ral unique challenges. Patients with rheumatoid arthritis often have additi
onal medical, anesthetic, and global musculoskeletal problems that are not
present in the patient with osteoarthritis. In terms of the knee, these pat
ients usually have osteopenia and may present with an array of bone and sof
t tissue deformities, each of which can impact the initial success and long
term durability of a total knee replacement. Despite these potential diffi
culties, the early and long term results of total knee arthroplasty in pati
ents with rheumatoid arthritis have proven to be excellent.