Abstract
The knee joint is capable of withstanding enormous loads, as may be readily appreciated by observing a downhill skier (figure 14.1). The correct alignment of the knee and its consequent stability depends on muscles, ligaments and body weight holding the normal contours of the tibial and femoral condyles in apposition. Damage to bone and soft tissue by rheumatoid disease will upset this delicate balance, causing pain, instability and deformity. Proliferation of the synovium and damage to the capsule, ligaments, cartilage and bone are characteristic of rheumatoid disease in the knee; secondary osteoarthritic changes may supervene later. The onset may be insidious or rapid. It begins with a synovitis and is frequently bilateral. Pain is an early dominant feature, whereas loss of mobility occurs late in the disease. Instability due to damage of ligaments and bone leads to progressive valgus or varus deformity.
Stress and strain on the knees of a downhill skier (Farrell-Kästle)
Weight-bearing X-rays reveal instability (G. Arden)
The Brattström stress method (H. Brattsrom)
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© 1980 Alexander Benjamin and Basil Helal
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Benjamin, A., Helal, B. (1980). The Knee. In: Surgical Repair and Reconstruction in Rheumatoid Disease. Palgrave, London. https://doi.org/10.1007/978-1-349-04135-0_14
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DOI: https://doi.org/10.1007/978-1-349-04135-0_14
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