Challenges Faced During Primary Total Knee Arthroplasty in Rheumatoid Knee in Females in the 5th Decade with Severe Osteoporosis

Introduction: Rheumatoid Arthritis [RA] is a chronic inflammatory disorder of the synovium resulting in joint destruction. The knee is among the most commonly affected joints in RA and advanced arthritis of the involved joint is associated with poor prognosis contributing to patient pain and disability. In advanced disease, Total Knee Arthroplasty [TKA] has proven to be the most successful intervention that reduces knee pain and improves physical function in RA patients. Aim: The aim of our study was to correlate the pre-operative radiographic findings of advanced knee rheumatoid arthritis with the intraoperative challenges and critical evaluation of intraoperative findings in lieu of severe osteoporosis. Materials and methods: A total of 30 total knee arthroplasties were performed for 24 females belonging to the fifth decade in a tertiary care centre for rheumatoid arthritis of the knee joint with a posterior stabilized knee. Patients were regularly followed up and were assessed at the end of 5 years for the function of the knee joint, quality of life, ability to walk and perform routine daily activities, local signs of infection, activity of the disease and general condition. Results and conclusion: Thorough pre-operative evaluation along with awareness about the possible intra-operative complications and challenges should be borne in mind while performing total knee arthroplasty in rheumatoid knees. No article till date has mentioned about the intra-operative challenges faced during total knee arthroplasty in rheumatoid knee.