title: Cementless total knee arthroplasty in chronic inflammatory rheumatism.
abstract: BACKGROUND
  We report a short-term monocentric retrospective evaluation of cementless total knee arthroplasty (TKA) in a population suffering from chronic inflammatory rheumatism.
  
  
  METHODS
  We have reviewed 23 patients (34 knees) with an average age of 55 years (range 26-78), bearing a TKA for chronic inflammatory rheumatisms with a 6-year follow-up (range 3-12); 78% suffered from rheumatoid arthritis and 15% from juvenile rheumatoid arthritis. We used a cementless total prosthesis sacrificing the posterior cruciate ligament and bearing an ultra-congruent rotational tibial insert, the Natural Knee (NK2™) (Zimmer(®), Warsaw, IN, USA). At last follow-up, an independent surgeon performed a clinical assessment for pain, function and quality of life using International Knee Documentation Committee score, International Knee Society (IKS) score and Devane's score. A radiographic study evaluated secondary fixation according to the radiographic index of the Knee Society and according to Ewald's score.
  
  
  RESULTS
  The mean postoperative IKS score was 83 points (range 40-100) for the knee score and 74 points (range 20-100) for the function score. Radiographic assessment came across only one case of loosening, concerning the tibial component on an asymptomatic patient. We came across the following complications: 1 early infection, 2 important postoperative flessum deformity having needed an arthrolysis, 1 supracondylar fracture of the femur and 1 fracture of the patellar component. Survival rate at 6-year follow-up is 97% taking into account one case of revision.
  
  
  CONCLUSIONS
  Non-cementation of this implant in chronic inflammatory rheumatism does not result in a higher rate of loosening. In this series, patients own satisfaction, function of the knee and survival rate are rather good.
  
  
  METHODS
  Retrospective, no control group, Level IV.
authors.affiliation: Department of Orthopaedics and Traumatology, CHU Jean Minjoz, 25030, Besançon, France, jonathan.buchheit@gmail.com.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Buchheit
authors.forename: Antoine
authors.initials: A
authors.lastname: Serre
authors.forename: Xavier
authors.initials: X
authors.lastname: Bouilloux
authors.forename: Marc
authors.initials: M
authors.lastname: Puyraveau
authors.forename: Laurent
authors.initials: L
authors.lastname: Jeunet
authors.forename: Patrick
authors.initials: P
authors.lastname: Garbuio
mesh_terms: D000328:Adult; D000368:Aged; D001171:Arthritis, Juvenile / Q000601:surgery*; D001172:Arthritis, Rheumatoid / Q000601:surgery*; D019645:Arthroplasty, Replacement, Knee / Q000295:instrumentation / Q000379:methods*; D005260:Female; D006801:Humans; D007720:Knee Prosthesis; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
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