Arthroplasty iSAWE 1

Question 51 year-old

Rheumatoid Arthritis with with right knee joint destruction for consideration of a total knee arthroplasty.

What are the major orthopaedic manifestations of rheumatoid arthritis? What must you consider to plan for the operation and what prosthesis would you consider?

Orthopaedic manifestations of rheumatoid arthritis

  1. General
    • Most common autoimmune disorder
    • Production of synovial Pannus and micro vascular proliferation/obstruction
    • Synovitis of soft tissue, capsule, ligaments then bone
  2. Hands
    • MCP ulnar drift
    • Rheumatoid nodules
    • Arthritis Mutilans
    • Swan neck deformity
    • Boutonniere
  3. Wrist
    • Caput ulna
  4. Elbow
  5. Shoulder
  6. Hip
  7. Knee
  8. Ankle
  9. Foot

Intraoperative considerations

Post-operative considerations