Japanese Journal of Rheumatology

, Volume 8, Issue 2, pp 157–165 | Cite as

Total knee arthroplasty on the disease activity of rheumatoid arthritis

  • Junnosuke Ryu
  • Kazusi Aibe
  • Atsuhiko Sakamoto
  • Iciro Simizu
Original Paper


The effects of total knee arthroplasty (TKA) on the disease activity of rheumatoid arthritis (RA) was investigated in the present study. The disease activity of RA in 58 patients who had undergone simultaneous bilateral TKA (116 knee joints) was examined before, and 1, 6 and 12 months and 3 and 5 years after the operation. The disease activity was assessed using the simplified Lansbury index according to the duration of morning stiffness, grip strength, joint count and erythrocyte sedimentation rate. In addition, C-reactive protein (CRP) and rheumatoid factor were also measured. The mean simplified Lansbury index and CRP significantly improved 1, 6 and 12 months after TKA surgery compared to preoperative levels. However, 3 and 5 years after TKA, the mean simplified Lansbury index indicated that the disease activity remained lower than the preoperative level in only 21 (36%) patients. The results of the present study demonstrate that TKA lowers RA activity for at least 1 year after surgery, and thus synovectomy and surgical resection of articular cartilage in the knee joint appear to have an anti-rheumatoid effect.

Key words

Rheumatoid arthritis total knee arthroplasty disease activity evaluation Lansbury index 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Aibe K, Ryu J, Saito Set al., Effects of total knee arthroplasty on activity of rheumatoid arthritis,Jpn J Rheum Joint Surg 15, 309–314 (1996) (in Japanese).Google Scholar
  2. 2.
    Larsen A, Dale K, Eek M, Radiographic evaluation of rheumatoid arthritis and related condition by standard reference films,Acta Radiol Diagn 18, 481–491 (1977).Google Scholar
  3. 3.
    Lansbury J, Hautt DD, Quantitation of the manifestations of rheumatoid arthritis. Area of joint surfaces as an index to total joint inflammation and deformity.Am J Med Sci 232, 150–155 (1956).PubMedCrossRefGoogle Scholar
  4. 4.
    Lansbury J, Numerical method of evaluating the status of rheumatoid arthritis,Ann Rheum Dis 16, 101–107 (1957).Google Scholar
  5. 5.
    Bernstein MA, Synovectomy of knee-joint in chronic arthritis,Ann Surg 98, 1096–1108 (1933).PubMedCrossRefGoogle Scholar
  6. 6.
    Lane V, Vainio K, Orthopedic surgery in rheumatoid arthritis,Bull Rheum Dis 15, 360–366 (1964).Google Scholar
  7. 7.
    Mori M, Surgery of rheumatoid arthritis of knee joint,Rheumatism 20, 35–42 (1964).PubMedGoogle Scholar
  8. 8.
    Aiden HP, Baker LD, Synovectomy of knee joint in rheumatoid arthritis,J Am Med Ass 187, 4–6 (1964).Google Scholar
  9. 9.
    Wakitani S, Ochi T, Owaki Het al., Indication of surgery treatment for rheumatoid knee,Rinsho Seikei Geka 24, 907–913 (1989) (in Japanese).Google Scholar
  10. 10.
    Takasugi K, The disease activity before and after the surgery in rheumatoid arthritis,Ryumachi 27, 459–460 (1987) (in Japanese).Google Scholar
  11. 11.
    Mitani H, Fuji M, Takeda Tet al., Follow-up study of total knee replacement,Cent Jpn J Orthop Traumat 29, 798–799 (1986) (in Japanese).Google Scholar
  12. 12.
    Ugai K, Ishikawa H, Hirohata Ket al., Interaction of polymorphonuclear leukocytes with immune complexes trapped in rheumatoid articular cartilage,Arthritis Rheum 26, 1434–1441 (1983).PubMedCrossRefGoogle Scholar
  13. 13.
    Kaufman RL, Tong I, Beardmore TD, Prosthetic synovitis. Clinical and histologic characteristics,J Rheumatol 12, 1066–1074 (1985).PubMedGoogle Scholar
  14. 14.
    Tateisi H, Yamada H, You Ket al., Should patella be replaced or not during TKA in RA,Cent Jpn J Orthop Traumat 34, 1365–1366 (1991) (in Japanese).Google Scholar

Copyright information

© VSP and Japanese Rheumatism Association 1998

Authors and Affiliations

  • Junnosuke Ryu
    • 1
  • Kazusi Aibe
    • 1
  • Atsuhiko Sakamoto
    • 1
  • Iciro Simizu
    • 1
  1. 1.Department of Orthopaedic SurgeryNihon University School of MedicineTokyoJapan

Personalised recommendations