title: Posterior cruciate ligament-retaining total knee arthroplasty in patients with rheumatoid arthritis.
abstract: BACKGROUND
  Although initial reports on posterior cruciate ligament-retaining total knee arthroplasty in patients with rheumatoid arthritis have been encouraging, a high rate of late instability necessitating revision has been reported recently. The purpose of the present prospective study was to analyze the results of posterior cruciate ligament-retaining total knee arthroplasty in patients with rheumatoid arthritis.
  
  
  METHODS
  Seventy-two posterior cruciate ligament-retaining total knee arthroplasties in fifty-one patients with rheumatoid arthritis were studied prospectively. All procedures were performed with the Miller-Galante I prosthesis. Eighteen patients (twenty-four knees) died before the eight-year follow-up and one patient (two knees) was lost to follow-up, leaving forty-six knees (thirty-two patients) for review. These forty-six knees were evaluated clinically (with particular attention to posterior instability) and radiographically at annual intervals for a mean of 10.5 years (range, eight to fourteen years).
  
  
  RESULTS
  Forty-four (95%) of forty-six knees had a good or excellent result at a mean of 10.5 years. However, nine (13%) of the original seventy-two knees had revision of the implant, with six of the revisions performed because of failure of a metal-backed patellar component. The rate of survival at ten years was 93% 4% with femoral or tibial revision for any reason as the end point and 81% 5% with any reoperation as the end point. There was no aseptic loosening in any knee. Posterior instability was identified clinically and/or radiographically in two (2.8%) of the original seventy-two knees; both unstable knees were in the same patient.
  
  
  CONCLUSIONS
  Posterior cruciate ligament-retaining total knee arthroplasty yielded satisfactory clinical and radiographic results in patients with rheumatoid arthritis at intermediate-term follow-up (mean, 10.5 years). Therefore, we believe that it remains an excellent treatment option for these patients.
authors.affiliation: New Mexico Orthopaedics, Albuquerque 87106, USA.
authors.forename: M J
authors.initials: MJ
authors.lastname: Archibeck
authors.forename: R A
authors.initials: RA
authors.lastname: Berger
authors.forename: R M
authors.initials: RM
authors.lastname: Barden
authors.forename: J J
authors.initials: JJ
authors.lastname: Jacobs
authors.forename: M B
authors.initials: MB
authors.lastname: Sheinkop
authors.forename: A G
authors.initials: AG
authors.lastname: Rosenberg
authors.forename: J O
authors.initials: JO
authors.lastname: Galante
mesh_terms: D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007593:Joint Instability / Q000000981:diagnostic imaging / Q000601:surgery; D008297:Male; D008875:Middle Aged; D016119:Posterior Cruciate Ligament; D011446:Prospective Studies; D011474:Prosthesis Design; D011859:Radiography; D016896:Treatment Outcome