Long-term results of total knee arthroplasty in class 3 and 4 rheumatoid arthritis.

One hundred four total knee arthroplasties in 67 patients with class 3 and 4 rheumatoid arthritis were reviewed clinically and radiographically at an average of 12.7 years. The Hospital for Special Surgery knee scores were good to excellent in 84 knees (81%). Seventeen knees (16%) were rated as fair, and three knees (3%) as poor. The average range of motion at follow-up examination was 95 degrees. Six knees failed due to delayed sepsis (4.1%), and two failed due to aseptic loosening. At a follow-up period of 15 years, the survivorship analysis suggests a 91% probability of the arthroplasty remaining functional in situ. Cemented total condylar knee arthroplasties in severe rheumatoid arthritis provide durable pain relief and restoration of function.