Minimum 4-year follow-up of the PCA total knee arthroplasty in rheumatoid patients.

One hundred twenty-one consecutive nonrandomized primary total knee arthroplasties in 94 patients were performed between 1980 and 1984 using the Porous-Coated Anatomic prosthesis in patients with a diagnosis of severe rheumatoid arthritis. Of the 94 patients, 81 patients were able to be followed for more than 4 years, with the remaining 13 dying from unrelated causes prior to the 48-month follow-up. Of those arthroplasties with 48-month follow-up, 55 were uncemented and 26 were cemented. An 81% good to excellent result was seen for the cemented group and a 91% good to excellent result for the uncemented group. The postoperative arc of motion for the cemented group was 94 degrees, with the postoperative arc of motion in the uncemented group being 102 degrees. In evaluation of component interfaces, there were almost no lucencies seen among the femoral group, with no component failures in either group. Thirty-six percent of the uncemented group developed nonprogressive radiolucent lines along the tibial tray; 97% of these radiolucencies were less than 1 mm. Complications in the cemented group included a revision of one patellar and one tibial component for component loosening. In the uncemented group, complications included one case of deep sepsis following an intra-articular injection, loosening of two patellar components requiring revision, and loosening of two tibial components requiring revision.