A Comparative Study of Total Knee Arthroplasty Outcome for Stiff Knee with or without Sequential Antirheumatic Drug Treatment

Abstract

BackgroundTo evaluate influence of antirheumatic drug treatment on knee function of patients with stiff knee after total knee arthroplasty (TKA). MethodsTwenty-seven patients (44 knees) of active RA (rheumatoid arthritis) or AS (ankylosing spondylitis) with stiff knee were included in this study. And they were divided into two groups according to continue antirheumatic drug treatment or not after TKA: the therapeutic group (16 patients, 27 knees) and the controlled group (11 patients, 17 knees). The outcomes were assessed by Knee Society Score (KSS), Visual Analogue Scale (VAS), range of motion (ROM) (at week 6, month 6, year 1 and year 2), “Forgotten Joint” Scale (FJS), with or without crutch, satisfaction and revision (at year 2). The knee prosthetic loosening was evaluated by the followed X-ray at each following time. ResultsThe mean follow-up time was 51 months (34-69 months). The KSS were higher at week 6 after TKA in the therapeutic group (p < 0.05), however, the functional scores of KSS at month 6, year 1 and year 2 in the controlled group were more points improved. The therapeutic patients preferred the knee more at month 6, year 1 and year 2. The differences of KSS clinical scores (at month 6, year 1 and year 2), VAS, ROM, Crutch and FJS between the two groups were not statistically significant (p＞0.05). ConclusionFor patients with stiff knees, the sequential antirheumatic drug treatment after TKA had no effect on postoperative KSS, but can improve the satisfaction.Level of evidenceTherapeutic Level II. See Instructions for Authors for a complete description of levels of evidence.