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DO WE NEED TO REPLACE THE PATELLA IN RHEUMATOID DISEASE – A COMPARATIVE STUDY WITH MINIMUM 8 YEAR REVIEW



Abstract

Statement of purpose: We studied anterior knee function in a cohort of patients with either osteoarthritis or rheumatoid disease who had undergone knee replacement in a single unit using a standard implant.

We identified a consecutive series of patients who had undergone knee replacement surgery for either osteoarthritis or rheumatoid disease between 1990 and 1995 under the care of a single surgeon using the same implant and surgical technique. There were ninety patients in each group. All were examined and underwent radiography of the anterior compartment. Data was collated for Hospital for Special Surgery (HSS) score, Western Ontario and McMasters Universities Osteoarthritis Index (WOMAC) score, a specific patellar score and a Visual Analog score (VAS).

Results: There were no discernible differences between the rheumatoid and osteoarthritis groups in all the measured scores, with good anterior knee function noted in both.

Conclusion: Based on our outcome studies in a matched group of patients no differences were found for anterior knee function between osteoarthritis or rheumatoid disease. We do not routinely resurface the patella and do not consider there to be any particular indication for such in the rheumatoid disease patient.

Correspondence should be addressed to Roger Smith, Honorary Secretary, BASK c/o Royal College of Surgeons, 35 – 43 Lincoln’s Inn Fields, London WC2A 3PN