Analysis of the results of the knee joint endoprosthetics in patients with rheumatoid arthritis

Mykhaylo Poluliakh, Sergey Gerasimenko, Valeriy Chernjak

Abstract


Proceeding from the analysis of treatment of 78 patients with rheumatoid arthritis who underwent 104 operations of the total knee joint arthroplasty, the authors studied anatomical-functional changes in the knee joint and the injured limb, and singled out the main factors, which produce their effect of the arthroplasty result. It was found out that flexion contracture of the knee joint occurred in 62.5 % of cases, and axial deformity in 43.27 %, with more than 20° in 9.62 %. A system of preparation for knee joint arthroplasty was developed. The above system includes elimination of the flexion contracture in the knee joint by stage-by-stage redressments with application of plaster bandages and using Volkov-Oganesian device for stable contractures. The technique of arthroplasty for cases of rigidity and ankylosis in the knee joint was improved; bone defect autoplasty was used for those bones, which form the knee joint. The suggested system for preparing patients for arthroplasty and the improved technique of the knee joint arthroplasty make it possible to eliminate the flexion contracture, thereby avoiding excessive resection of the bone joint ends during the operation and preventing complications in the neurovascular bundle in the postoperative period.


Keywords


rheumatoid arthritis; knee joint; arthroplasty; flexion contracture

References


Балабанова Р. М. Ревматоидный артрит // Ревматические болезни / Под. ред. В.А. Насоновой, Н. В. Бунчука. — М.: Медицина, 1997. — С. 257–294.

Ревматоидное поражение коленного сустава. Библиотека практикующего врача / С.И. Герасименко, Е.Т. Скляренко, М.В. Полулях [и др.]. — Киев, 2004. — 140 с.

Загородний Н.В. Эндопротезирование коленного сустава: сб. науч. работ «Трансплантаты и имплантаты в хирургии крупных суставов». — Н. Новгород, 2000. — С. 25–27.

Коваленко В.М. Ревматологія в Україні: підсумки та перспективи / В.М. Коваленко // Укр. ревматол. журн. — 2005. — № 3 (21). — С. 3–11.

Остеопороз: эпидемиология, клиника, диагностика и лечение / Н.А. Корж, В.В. Поворознюк, Н.В. Дедух, Н.А. Зупанец. — Золотые страницы. 2002. — С. 380–410.

Эндопротезирование при тяжелом проявлении ревматоидного артрита / А.Е. Лоскутов, T. Siebel, А.Е. Олейник, Д.А. Синегубов // Ортопед. травматол. — 2002. — № 4. — С. 114–116.

Лоскутов А.Е. Вопросы профилактики осложнений при тотальном эндопротезировании коленного сустава / А.Е. Лоскутов, М.Л. Головаха, А.Е. Олейник // Ортопед. травматол. — 2002. — №1. — С. 74–78.

Окороков А.Н. Диагностика болезней внутренних органов: Практическое руководство: В 3 Т. — Витебск: Белмедкнига. — 1998. — Т. 2 — 576 с.

Скляренко Е.Т. Хирургическое лечение инфекционного неспецифического полиартрита / Е.Т. Скляренко. — К.: Здоров’я, 1971. — 189 с.

Atsushi K. Survival after total joint arthroplasty in patients with rheumatoid arthritis. Comparison of the postoperative life expectancies and survival by initial operative years: 1970s and 1980s group versus 1990s group / K. Atsushi, E. Yoshito, T. Masami // Modern Rheumatology. — 2004. — V. 14, №6. — P. 466–469.

Gaveda K. Function of patellofemoral joints after total knee replasment with polyethylene patellar articular surface in osteoarthritis and rheumatoid arthritis / K. Gaveda, M. Jablonsky // Journal of Orthopaedics and Traumatology. — 2000. — V. 1, № 2. — P. 79–82.

Joseph J. Preliminary results of Miller-Galante uncemented total knee arthroplasty / J. Joseph, E.E. Kaufman // Int. Orthop. — 1990. — V. 13, №5. — P. 511–516.

Keblish P.A. The lateral approach for total knee arthroplasty / P.A. Keblish // J. Knee Surg. — 2003. — V. 16. — P. 62–68.

Total Knee Arthroplasty in Juvenile Rheumatoid Arthritis / D.H. Palmer, K.J. Mulhall, C.A. Thompson [et al.] // J. Bone Jt. Surgery. — 2005. — V. 87-A. — P. 1510–1514.

Radmer S. Totalendoprothetischer Kniegelenkersatz mit dem Rotating Hinge Knee bei Patienten mit Rheumatoider Arthritis / S. Radmer, R. Andresen, M. Sparmann // Akt Rheumatol. — 2007. — V. 32. — S. 34–39.

Long-term results of the uncemented Low Contact Stress total knee replacement in patients with rheumatoid arthritis / S. Sharma, F. Nicol, M.G. Hullin [et al.] // J. Bone Jt. Surgery. — 2005. V. 87-B, Issue 8. — P. 1077–1080.

Soo Hoo N.F. Factors predicting complication rates following total knee replacement / N.F. Soo Hoo, J.R. Lieberman, C.Y. Ko // J. Bone Jt. Surgery. — 2006. — V. 88-A. — P. 480–485.




DOI: https://doi.org/10.15674/0030-59872009338-42

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