Mj. Archibeck et al., Posterior cruciate ligament-retaining total knee arthroplasty in patients with rheumatoid arthritis, J BONE-AM V, 83A(8), 2001, pp. 1231-1236
Citations number
23
Categorie Soggetti
Ortopedics, Rehabilitation & Sport Medicine","da verificare
Background: Although initial reports on posterior cruciate ligament-retaini
ng total knee arthroplasty in patients with rheumatoid arthritis have been
encouraging, a high rate of late instability necessitating revision has bee
n reported recently. The purpose of the present prospective study was to an
alyze the results of posterior cruciate ligament-retaining total knee arthr
oplasty in patients with rheumatoid arthritis.
Methods: Seventy-two posterior cruciate ligament-retaining total knee arthr
oplasties in fifty-one patients with rheumatoid arthritis were studied pros
pectively. All procedures were performed with the Miller-Galante I prosthes
is. Eighteen patients (twenty-four knees) died before the eight-year follow
-up and one patient (two knees) was lost to follow-up, leaving forty-six kn
ees (thirty-two patients) for review. These forty-six knees were evaluated
clinically (with particular attention to posterior instability) and radiogr
aphically at annual intervals for a mean of 10.5 years (range, eight to fou
rteen years).
Results: Forty-four (95%) of forty-six knees had a good or excellent result
at a mean of 10.5 years. However, nine (13%) of the original seventy-two k
nees had revision of the implant, with six of the revisions performed becau
se of failure of a metal-backed patellar component. The rate of survival at
ten years was 93% +/- 4% with femoral or tibial revision for any reason as
the end point and 81% +/- 5% with any reoperation as the end point. There
was no aseptic loosening in any knee. Posterior instability was identified
clinically and/or radiographically in two (2.8%) of the original seventy-tw
o knees; both unstable knees were in the same patient.
Conclusion: Posterior cruciate ligament-retaining total knee arthroplasty y
ielded satisfactory clinical and radiographic results in patients with rheu
matoid arthritis at intermediate-term follow-up (mean, 10.5 years). Therefo
re, we believe that it remains an excellent treatment option for these pati
ents.