Experience of Hinge Total Knee Arthroplasty for Knees Severely Damaged by Rheumatoid Arthritis

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  • 関節リウマチによる高度機能不全膝におこなった蝶番型人工膝関節置換術の経験

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Abstract

Hinge-type total knee arthroplasty (hinge TKA) is often used for functional reconstruction in cases of severe bone loss and joint instability. We report two patients with knees severely damaged by rheumatoid arthritis (RA), treated with hinge TKA (Finn Knee System, BIOMET), who showed good improvements in walking ability from an early postoperative stage. Case 1: a female, aged 66 years, with class III stage IV RA. Her left knee was severely damaged; (figure 1) . She lost the ability to walk at about 65 years old, and crawled on the ground (figure 2) . Case 2: a female aged 55 years, also with class III stage IV RA. She received right TKA at age 42 and left TKA at 43, but her left knee became unstable from around age 52, and it continued to deteriorate.<BR>Both patients achieved a stable gait soon after hinge TKA. The postoperative Japan Orthopaedic Association score (JOA score) was 30 points preoperatively for case 1, but at final follow-up three years postoperatively, the JOA score was 83 points, showing excellent progress. For case 2, the preoperative JOA score was 46, and at final follow-up two years postoperatively, it had improved to 75 points, again indicating excellent progress.<BR>For these two patients, hinge-TKA provided immediate pain relief even at early follow-up, and allowed early weightbearing and aggressive rehabilitation, without evidence of early mechanical failure. The two patients were satisfied with these operation results.

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