Knee Surgery for Rheumatoid Arthritis.
Last updated Thursday, February 10, 2005
Considering surgeryWhat kinds of surgery are recommended for rheumatoid arthritis of the knee?
Who should consider knee surgery for rheumatoid arthritis for rheumatoid arthritis of the knee and in what cases? RA patients who have unrelenting knee pain and destructive arthritis of
their knee joint that does not respond favorably to medical management
should consider total knee replacement. RA patients with knee
involvement in early stages, who do not yet have destructive arthritis,
yet have pain and synovitis that does not respond to medical
managementun should consider knee arthroscopy.What happens if nothing is done for rheumatoid arthritis of the knee (best case/worst case scenarios)? The best case scenario includes inactivity and decreased mobility in
conjunction with antirheumatic medication and intraarticular steroids
can cause some improvement of symptoms.
A worst case scenario might be severe destruction of the knee joint
and associated osteoporosis and reduced physical capacity potentially
leading to a compromised knee replacement at a later stage with a less
predictable outcome. What options exist for surgery for rheumatoid arthritis of the knee? In early stages, arthroscopic or open synovectomy can be of benefit.
In later stages, when the joint space has been destroyed, bony
destruction and deformity has occurred and knee stiffness has set in,
total knee replacement is the optimal and most reliable treatment.When performed by an experienced surgeon, how effective is knee surgery for rheumatoid arthritis for rheumatoid arthritis of the knee likely to be and how long will the benefit last? Knee replacements in RA are extremely successful. More than 80% of patients will have a satisfactory result for 12-15 years.How urgent is knee surgery for rheumatoid arthritis for rheumatoid arthritis of the knee? Knee replacement surgery is an elective procedure and should be done
only after non-surgical medical management has failed. Once indicated,
postponing the surgery for an extended period of time (months or years)
only leads to increased disability, disuse osteoporosis, and skeletal
complications that can make surgery more difficult and potentially
compromise the final result.What are the most frequent and most serious risks of knee surgery for rheumatoid arthritis for rheumatoid arthritis of the knee? How common are they? Infection, component failure and nerve damage are the most serious
complications. Infection occurs in approximately 4% of patients with RA
which is higher than in the osteoarthritis patient population. This is
thought to be due to systemic immune compromise, frail skin and
impaired wound healing. Peroneal nerve injury can occur with correction
of severely deformed knees. Postoperative stiffness is common and may
be aggravated by generalized muscular weakness and disability.
If risks occur during or after knee surgery for rheumatoid arthritis for rheumatoid arthritis of the knee how are they managed? These complications can necessitate a revision knee replacement. If an
infection occurs then the prosthesis needs to be removed. A six week
period of antibiotic treatment is needed and if the infection is cured
a revision knee replacement can be done. Wound complications may
require additional surgery. Nerve injuries are managed by special knee
positioning and modified rehabilitation.Surgery for Rheumatoid arthritis of the knee at the University of Washington If you are interested in making an appointment to discuss this procedure, you can request an appointment using our online referrals website. To request a referral online, please click here. You can also call 206-598-4288 (outside the Seattle area: 800-440-3280) to make an appointment.
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