Post-operative infection in total knee arthroplasty in steroid dependent rheumatoid arthritis
Background: Rheumatoid arthritis (RA) is a chronic autoimmune inflammatory disease which primarily affects and damages synovial joints. Patients with RA will therefore often undergo joint replacement surgery. Patients with rheumatoid arthritis are more prone to infection than patients with osteoarthritis knee because of use of steroids, poor bone quality, and more flexor contracture of muscle.
Objective: Main purpose of the study is to identify the complication in patients undergo total knee replacement having rheumatoid arthritis.
Material and Methods: This is a retrospective study of 100 patients operated for cruciate sacrificing total knee arthroplasty “between” January 2012 to January 2016 at B. J. Medical College, Civil Hospital Ahmedabad.
Results: The mean age of patients in study was 58.3 years. Out of the total 100 patients in our study 75 were females and 25 were males. Average duration of follow up was 3.7 years. Most common complication is late infection which is approximately 5%. Wound Necrosis, Quadriceps failure, immediate infection and Periprosthetic fracture were the other noted complications. Crude survival rate was 95 percent.
Conclusion: Total knee replacement mainly relieves pain in most of the patients. There is twice increase the risk of infection in total knee arthroplasty done in rheumatoid patients compare to osteoarthritic patients. The complication following total knee replacement in rheumatoid arthritis are infection, periprosthetic fracture, quadriceps extension failure, late healing, skin necrosis etc.
Keywords: Infection, Rheumatoid arthritis, Total knee replacement