alexa Revision Total Knee Arthroplasty due to Rheumatoid Arth
ISSN: 2167-7921

Journal of Arthritis
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Case Report

Revision Total Knee Arthroplasty due to Rheumatoid Arthritis after Unicompartmental Knee Arthroplasty: A Case Report

Kazue Hayakawa*, Hideki Date, Sho Nojiri and Harumoto Yamada
Department of Orthopedic Surgery, Fujita Health University School of Medicine, Toyoake, Aichi, Japan
Corresponding Author : Kazue Hayakawa, MD, PhD
Department of Orthopedic Surgery
Fujita Health University School of Medicine
Dengakugakubo, Kutsukake-cho, Toyoake
Aichi, 470-1192, Japan
Tel: +81-562-93-2169, +81-562-93-9252
E-mail: [email protected]
Received: January 28, 2016 Accepted: February 11, 2016 Published: February 20, 2016
Citation:Hayakawa K, Date H, Nojiri S, Yamada H (2016) Revision Total Knee Arthroplasty due to Rheumatoid Arthritis after Unicompartmental Knee Arthroplasty: A Case Report. J Arthritis 5:189. doi:10.4172/2167-7921.1000189
Copyright: © 2016 Hayakawa K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Objective: We report a rare case of revision total knee arthroplasty for monoarthritis of the knee due to rheumatoid arthritis (RA). Case: The patient was a 72-year-old woman, who underwent revision surgery at 8 years and 7 months after left unicompartmental knee arthroplasty. Bacteriological examination of the synovial fluid was negative, and no crystals were found by microscopic examination. When the Knee Society score was determined, the knee score was 43 points and the function score was 45 points. No periprosthetic radiolucent lines were observed and there was no loosening. Erosion of the lateral femoral and tibial condyles was observed. CRP 3.6 mg/dL, erythrocyte sedimentation rate 129 mm/h, RF 101 U/mL, MMP3 732.2 ng/mL, anti-CCP antibody 190.3 U/mL. Revision TKA was done with a NexGen CR Flex (Zimmer Corp.) RA was diagnosed by histopathological examination of the synovium. Detailed investigation with bone scintigraphy and gallium scintigraphy did not identify inflammation of any other joints. However, pain and swelling of the right knee joint appeared 5 months after revision surgery, and right TKA was performed. Histopathological examination of the synovium resected from the right knee also revealed findings typical of RA. Discussion: Revision TKA is likely to increase in the future because of more patients undergoing UKA and an increase in the age of onset of RA. If knee pain occurs in patients after unicompartmental knee arthroplasty, monoarthritis due to RA should be considered as a possibility. Accordingly, we should follow patients after UKA while keeping the possibility of RA in mind.


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