Abstract
A prospective study on total knee replacement in patients with Juvenile Idiopathic Arthritis was carried out. There were 31 knee replacements in 17 patients; 12 were female. Bilateral procedures were performed in 11 patients; 10 staged during a single admission and 1 performed in a single procedure. The mean age was 19 years (range, 14–26), and the mean follow-up was 23 months (range, 6–44). The surgery was complicated in 9 cases by a previous distal femoral osteotomy. The results were assessed using the Hospital for Special Surgery (HSS) scoring system. A cruciate sacrificing implant was used in all cases, and the patella was resurfaced in 25/31.
The pre-operative mean arc of motion was 62° (range 10°–90° ) and this averaged 89° (range, 20° –115°) at latest follow-up. The pre-operative mean fixed flexion 17° (range, 0° –15° ). The mean pre-operative HSS score was 36 (range, 8–59), and the mean at latest follow-up was 81 (range, 67–95). There has been no sign of aseptic loosening on serial radiographs over the follow-up period. One patient developed a deep infection at 20 months requiring a 2-stage revision and one patient developed a perforated duodenal ulcer postoperatively.
The clinical results are very satisfactory, allowing patients to regain their mobility and independence. The early radiographic results are very encouraging despite the poor bone quality and severe deformities that require correction.
The abstracts were prepared by Mr Simon Donell. Correspondence should be addressed to him at the Department of Orthopaedics, Norfolk & Norwich Hospital, Level 4, Centre Block, Colney Lane, Norwich NR4 7UY, United Kingdom.
