PROBLEM

A 38 years old Italian lady, who was diagnosed with Juvenile rheumatoid arthritis 20 years ago, was treated with DMARDs. She gradually developed deformity of the left hip, both knees and both ankles.

She underwent cementless total knee replacement of the left knee 10 years ago in Italy. At present she has a 30 ^o fixed flexion deformity of the left hip, 30^o fixed flexion deformity of the left knee and a 30^o fixed equinus deformity of the left ankle.

She has no pain in the operated knee but can flex the knee from 30^o to 80^o. She has severe pain in the right knee, aggravated on walking. She has to use a walking stick for walking and finds it extremely difficult to sit in a chair and to get up, on account of the stiffness in her knees.

RADIOGRAPHS OF THE LEFT KNEE- 10yrs post- op

PRE- OP CLINICAL PICTURES

PRE- OP RADIOGRAPHS

TREATMENT

She underwent a total knee replacement of the right knee using cementless femoral component and cemented tibial component. (TC PLUS, PLUS ORTHOPEDICS, SWITZERLAND)

INTRA-OPERATIVE

POST- OP RADIOGRAPHS

RESULTS

At the end of 3 months, she has no pain in the right knee; she is able to straighten the right knee fully and bend it to 90^o.

With physiotherapy, the deformity in the left hip and left knee has decreased slightly. She has now approached us for surgery on the left hip

RESULT - 3 MONTHS