Case Report

Total knee arthroplasty for rheumatoid knee with bilateral, severe flexion contracture: report of three cases

Authors

Shuji Abe¹, Kozo Kohyama¹, Hironobu Yokoyama¹, Shigeru Matsuda¹, Yasuhiro Terashima¹, Natsuko Nakagawa¹, Yasuhiro Saegusa² and Hiroyuki Fujioka³

1. Department of Orthopedic Surgery, Kohnan Kakogawa Hospital, 1545-1 Saijo, Kanno-cho, Kakogawa Hyogo, 675-8545, Japan
2. Department of Orthopedic Surgery, Kohnan Hospital, Kobe, Japan
3. Department of Orthopedic Surgery, Kobe University Graduate School of Medicine, Kobe, Japan

Received:

6 December 2007

Accepted:

7 April 2008

Published online:

30 May 2008

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Abstract

The treatment of patients with severe flexion contracture of the rheumatoid knee, deprived of ambulation for long periods of time, is challenging. Based on three cases, we indicate the potential risks of posterior dislocation of the knee after total knee arthroplasty. In this pathological condition, surgeons must carefully select the type of implant in order to avoid this serious complication. We also emphasize the importance of working on disuse muscle atrophy of trunk (back, abdominal) and lower limbs, both of which play an integral role in ambulation. The personality of each rheumatoid patient should be carefully considered when considering surgical and rehabilitation options.

Key words

Knee joint - Flexion contracture - Rheumatoid arthritis - Total knee arthroplasty