Zusammenfassung
Introduction Erosive-destructive changes in rheumatoid arthritis particulary in the large joints of the lower limbs of ten result in the patient's immobility. The aim of this retrospective study was to weigh the benefits. of multiple joint replacement in, rheumatoid arthritis against,the specific complications. Materials and methods From January 1977 until 31 December 1998, 215 patients with ...
Zusammenfassung
Introduction Erosive-destructive changes in rheumatoid arthritis particulary in the large joints of the lower limbs of ten result in the patient's immobility. The aim of this retrospective study was to weigh the benefits. of multiple joint replacement in, rheumatoid arthritis against,the specific complications. Materials and methods From January 1977 until 31 December 1998, 215 patients with proven rheumatoid arthritis (according to the ACR classification) received three or four endoprostheses in the lover limbs. In a retrospective study with a standard questionnaire and evaluation of the patient re-cord, we were able to assess 201 rheumatoid patients (93.5%) who received 688 endoprostheses (93.7%), with 347 total hip protheses (THR) and 341 total knee prostheses (TKR). Results There was a significant improvement of the patient's ability to walk and in 16.9% of the cases even a remobilization of the rheumatoid patients who had been unable to walk before surgery. On the other hand, there were significant complications - in the majority of the cases (appr. 60%) with total knee replacement. Together the complications per implant had an extremely high complication rate of 43.8% (n=88) per rheumatoid patient. Discussion Due to the long-term follow-up of 22 years (1977 through 1998), we were able to demonstrate that with a new implant generation and a more a careful indication this unacceptable complication rate can be reduced considerably. However, the multiple joint replacement of the lower limbs remains a difficult method with a high complication rate and should therefore only be performed at orthopedic rheumatological centers.
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