Total condylar knee replacement in rheumatoid arthritis. A review of one hundred and seventeen knees.

Total condylar tricompartmental total knee replacement was performed in ninety-one patients (117 knees) with seropositive rheumatoid arthritis, all of whom were followed for at least two years postoperatively. Angular deformities of as much as 35 degrees of varus and 20 degrees of valgus angulation were seen preoperatively; postoperatively 85 per cent of the knees had alignment of between zero and 5 degrees of valgus angulation. One hundred and ten knees had less than 5 degrees of varus-valgus laxity on postoperative stress roentgenograms. The range of motion was not statistically increased except in those patients in whom there had been a severe flexion contracture preoperatively. Eighty-six per cent of the patients were either completely free of pain or had only mild barometric discomfort postoperatively, and 88 per cent had markedly increased walking ability after surgery. The majority of complications were related to problems with soft-tissue healing. Postoperative stability to anterior-posterior and valgus-varus stresses was obtained through a combination of implant design and soft-tissue ligament balancing.