Outcomes of Cementless Total Knee Arthroplasty in Patients With Rheumatoid Arthritis

The objective of this study was to evaluate implant survivorship, clinical outcomes, postoperative complications, and radiographic outcomes of cementless total knee arthroplasty (TKA) in patients who have rheumatoid arthritis (RA). Patients who underwent a primary cementless posterior-stabilized TKA and who had RA were reviewed. A total of 126 TKAs in 122 patients who had a mean follow-up of 4 years were analyzed. Implant survivorship was calculated. Postoperative clinical and radiographic follow-up was performed at approximately 6 weeks and 3 months and then annually. Changes in range of motion and Knee Society scores were noted. Radiographic evaluation was conducted as part of the follow-up process. Implant survivorship was 99.2%, with 1 aseptic failure. At final follow-up, mean extension and flexion were 2 degrees (range, 0 degrees-10 degrees) and 124 degrees (range, 95 degrees-140 degrees), respectively. Mean Knee Society pain and function scores were 92 points (range, 80-100 points) and 84 points (range, 70-90 points), respectively. There were no surgical complications. No progressive radiolucencies, loosening, or subsidence were noted except from the single aseptic failure reported. This study reports excellent survivorship and clinical and radiographic outcomes of cementless TKAs in RA patients. Although the decision regarding whether to use cemented or cementless TKAs in these patients should be based on surgeon experience and patient characteristics, the recent advances in implant fixation of cementless TKAs indicate no salient contraindications for RA patients.