The knee joint deformities in rheumatoid arthritis patients

Authors

  • Sergiy Herasymenko SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv, Ukraine
  • Myhailo Poluliakh SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv, Ukraine
  • Andriy Babko SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv, Ukraine
  • Andriy Herasymenko SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv, Ukraine
  • Dmytro Рoluliakh SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv, Ukraine
  • Dmytro Kachan SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv, Ukraine
  • Yuriy Kostogryz SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv, Ukraine
  • Maksym Duda SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv, Ukraine
  • Igor Huzhevskyi SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv, Ukraine

DOI:

https://doi.org/10.15674/0030-598720223-422-28

Keywords:

knee joint, Rheumatoid arthritis, frontal deformities, valgus deformity, varus deformity, total knee arthroplasty

Abstract

Knee joints injury in rheumatoid arthritis patients appear in 70 % cases. This is the most common cause of loss of work capacity, the ability to self-care. Patients become severely disabled, in that the disease is accompanied by deformations with the development of discordant positions of the lower limbs, which lead to a partial or complete loss of the function of support and walking, so this problem needs to be studied.  Objective. To make an analysis of orthopedic treatment of secondary arthrosis of knee joints in RA patients, complicated by deformities depending on the age and gender of the patient, stage, duration of the disease and activity of the inflammatory process. Methods. In this work we have analyzed the orthopedic treatment of 66 RA patients with secondary arthrosis with axial deformities, who underwent 75 total endoprosthetics between 2013 and 2020. Anamnestic data, clinical, biomechanical and statistical research methods were used. The obtained data were evaluated using the scale of Joseph J., Kaufman E. E. Results. The analysis of the results of knee joint replacement was followed in the period from 6 months to 5 years. The results were carried out according to the 100-point scale Joseph J., Kaufman E. E. (1990). Thus, the analysis of the results of total knee arthroplasty in patients with RA according to the scale of Joseph J., Kaufman E. E. showed that good results were obtained in 46 (79.31 %) patients, satisfactory results in 11 (18.97 %) and unsatisfactory results obtained in 1 (1.72 %) patients. The reliable relationship of the level of joint deformation with the level of disease activity and with the scale of Joseph J., Kaufman E. E. was researched. Other indicators are not reliably correlated with the level of joint deformation. As a result of pairwise comparisons of groups with each other using the Duncan test, a significant increase in the degree of joint deformation was found in the group with activity 3 compared to the group with activity 1. The use of basic or complex therapy does not reliably affect the degree of  joint deformation. Conclusions. Total knee joint replacement need patients with II stage of the 2nd phase of the disease and higher. In our opinion, this is the most optimal time for surgical treatment, which allows patients with RA to fully use the possibilities of an implanted endoprosthesis.

Author Biographies

Sergiy Herasymenko, SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv

MD, Doctor in Traumatology and Orthopaedics

Myhailo Poluliakh, SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv

MD, PhD, Prof.

Andriy Babko, SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv

MD, PhD

Andriy Herasymenko, SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv

MD, PhD in Orthopaedics and Traumatology

Dmytro Рoluliakh, SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv

MD, PhD in Orthopaedics and Traumatology

Yuriy Kostogryz, SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv

MD, PhD

Maksym Duda, SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv

MD, PhD

Igor Huzhevskyi, SI «Institute of Traumatology and Orthopedics of NAMS of Ukraine», Kyiv

MD, PhD in Orthopaedics and Traumatology

References

  1. Herasimenko, S. I. (2000). Orthopedic treatment of rheumatoid arthritis with lesions of the lower extremities [Ortopedychne likuvan-nya revmatoyidnoho artrytu pry urazhennyakh nyzhnikh kintsivok]. Kyiv: Press of Ukraine. (in Ukrainian)
  2. Yaremenko, O. B. (2006). Modern algorithm for diagnosing rheumatoid arthritis [Sovremennyy algoritm diagnostiki revmatoidnogo artrita]. Klinichna immunolohiia Aler-holohiia. Infektolohiia, 1 (2), 54–59. (in russian)
  3. Rossi, R., Rosso, F., Cottino, U., Dettoni, F., Bonasia, D. E., & Bruzzone, M. (2013). Total knee arthroplasty in the valgus knee. International Orthopaedics, 38(2), 273–283. https://doi.org/10.1007/s00264-013-2227-4
  4. Hayko, H. V. (2003). State of endoprosthetics in Ukraine and prospects for its development [Stan endoprotezuvannya v Ukrayini ta perspektyvy yoho rozvytku]: Proceeding sci-entific and practical conference on international participation “Total and revision arthroplasty of large joints”. Kyiv–Lviv. (in Ukrainian)
  5. Herasimenko, S. I. (1997). Complex orthopedic treatment of patients with rheumatoid arthritis with lesions of the lower extremi-ties [Kompleksne ortopedychne likuvannya khvorykh na revmatoyidnyy artryt z urazhennyam nyzhnikh kintsivok]. (DMSci) (Kyiv) (in Ukrainian)
  6. Yamashita, F., Funakoshi, N., Mori, D., & Kizaki, K. (2021). Long-term outcomes and duration of outdoor ambulation following primary total knee arthroplasty in patients with rheumatoid arthritis. Journal of Orthopaedic Science. https://doi.org/10.1016/j.jos.2021.01.014
  7. Lee, J. K., & Choi, C.-H. (2012). Total Knee Arthroplasty in Rheumatoid Arthritis. Knee Surgery & Related Research, 24(1), 1–6. https://doi.org/10.5792/ksrr.2012.24.1.1
  8. Jaffe, W. L., Dundon, J. M., & Camus, T. (2018). Alignment and Balance Methods in Total Knee Arthroplasty. Journal of the American Academy of Orthopaedic Surgeons, 26(20), 709–716. https://doi.org/10.5435/jaaos-d-16-00428
  9. Saidane, O., Gafsi, L., Tekaya, A. B., Mahmoud, I., Tekaya, R., & Abdelmoula, L. (2019). Joint Surgery in Tunisian Rheumatoid Arthritis Patients: Prevalence and Risk Factors. Archives of Rheumatology, 35(3), 426–434. https://doi.org/10.46497/archrheumatol.2020.7483
  10. Danoff, J. R., Moss, G., Liabaud, B., & Geller, J. A. (2013). Total Knee Arthroplasty Considerations in Rheumatoid Arthritis. Autoimmune Diseases, 2013, 1–6. https://doi.org/10.1155/2013/185340
  11. Sohail, M., Aresti, N., Hanna, S., Malik, A., & Khan, W. (2015). The Peri-operative Management of the Rheumatoid Patient Undergoing Total Knee Arthroplasty: A Review of Literature. Current Rheumatology Reviews, 11(1), 34–38. https://doi.org/10.2174/1573397111666150522095321
  12. Deshmukh, A. J., Rathod, P. A., Moses, M. J., Snir, N., Marwin, S. E., & Dayan, A. J. (2015). Does a non-stemmed constrained condylar prosthesis predispose to early failure of primary total knee arthroplasty? Knee Surgery, Sports Traumatology, Arthroscopy, 24(10), 3194–3199. https://doi.org/10.1007/s00167-014-3494-3
  13. Akpancar, S., & Turgut, H. (2016). Orthopedic Management of Total Knee Arthroplasty in the Patients with Rheumatoid Arthritis. Journal of Arthritis, 05(01). https://doi.org/10.4172/2167-7921.1000186

How to Cite

Herasymenko, S. ., Poluliakh, M. ., Babko, A. ., Herasymenko, A. ., Рoluliakh D. ., Kachan, D. ., Kostogryz, Y. ., Duda, M. ., & Huzhevskyi, I. . (2023). The knee joint deformities in rheumatoid arthritis patients. ORTHOPAEDICS TRAUMATOLOGY and PROSTHETICS, (3-4), 22–28. https://doi.org/10.15674/0030-598720223-422-28

Issue

Section

ORIGINAL ARTICLES