Aims: The purpose of the study was to analyse the results of 4 primary and 21 revision total knee replacements performed on 24 patients with rheumatic disease using the Dual Articular Knee prosthesis with a mean follow-up of 2.3 (1–8) years. Methods: Patient documents and pre- and postoperative radiographs were evaluated with respect to radiolucent lines, fractures, lateral patellar displacement, proper resection lines, implant þt and behaviour of bone grafts as well as implant migration or subsidence during the follow-up. One to 8 years after the surgery, an interview of 22 patients was arranged to settle the subjective contentment, functional ability and the longevity of replaced knees. Results: Indication of primary TKR was þxed valgus in one knee and severe instability in 3, and in revision TKR aseptic loosening and instability in 15 knees, instability without implant loosening in 2 and infection in 4 knees. A 2-stage procedure was performed for infected arthroplasties with a mean period of cement interposition of 3 months. All the 2-stage exchange procedures healed without complications. Four patellar tendon avulsions and one deep infection were encountered. Results were excellent in 82% of patients. Conclusion: Dual Articular Knee proved to be favourable both in demanding primary and revision arhroplasties in patients with rheumatic disease.

The presence of the connective tissue components fibronectin and the different types of collagen was demonstrated by histological and immunohistological methods in the granulation and scar tissue of a healing injury in rat muscle. The effects of physical activity on granulation tissue production, scar formation and muscle regeneration at various stages of healing were studied. It was shown that immobilisation after injury accelerates granulation tissue production, but if continued too long, leads to contraction of the scar and to poor structural organisation of the components of regenerating muscle and scar tissue. However, a certain period of immobilisation, about five days for rat muscle, is required to allow newly-formed granulation tissue to cover the injured area and to have sufficient tensile strength to withstand subsequent mobilisation. This mobilisation, at the correct interval, seems essential for the quicker resorption of scar tissue and the better structural organisation of the muscle.