To evaluate the safety and efficacy of total knee arthroplasty in treatment of rheumatoid arthritis in active stage.

Thirty-five patients (45 knees) with rheumatoid arthritis in active stage had undergone total knee arthroplasty (TKA) in Lanzhou Ganeral Hospital of PLA with at least two years follow-up from October 2010 to March 2015. There were 10 men (10 knees) and 25 women (35 knees), with an average age of (55±9) years. The patients with fever whocouldnot accepte operation were excluded. The rheumatoid factor, erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels of the patients were measured before treatment, one and two years after TKA treatment, and the KSS joint function scoring criteria was used to assess the functions. The symptoms and complications were also recorded. The data were statistically analyzed by SPSS 21.0 statistical software with pair-t test to compare the rheumatoid factor, ESR and CRP levels, so as the knee functions.

All the patients were followed up for average (4.2±1.6)years. Two years after TKA treatment, the indicators (rheumatoid factor, ESR, CRP) at two years after TKA treatment were significantly lower than those before treatment (P <0.01). All the functions of the knee joint were improved after TKA.The range of knee motion was improved from (53±13)°(42°-67°) to preoperative (93±11)° (82°-104°) at two years fellow up (t=27.461, P <0.01). The KSS knee score was improved from the preoperative (56±10) to the (88±8) at the last follow-up examination, and there was statistical difference between preoperative results and the results of the latest follow-up (t =68.731, P <0.01). No patients suffered wound dehiscence, delayed healing, infection and prosthesis loosening in follow-up.

TKA is safety and efficacy in treating the RA patients with active stage. Detailed evaluation and multidisciplinary cooperation at perioperative period, effective synovectomy of knee and correct TKA manipulation are necessary to reduce the risk of TKA surgery.