Total condylar tricompartmental total knee replacement was performed in
ninety-one patients (117 knees) with seropositive rheumatoid arthritis, all
of whom were followed for at least two years postoperatively. Angular
deformities of as much as 35 degrees of varus and 20 degrees of valgus
angulation were seen preoperatively; postoperatively 85 per cent of the
knees had alignment of between zero and 5 degrees of valgus angulation. One
hundred and ten knees had less than 5 degrees of varus-valgus laxity on
postoperative stress roentgenograms. The range of motion was not
statistically increased except in those patients in whom there had been a
severe flexion contracture preoperatively. Eighty-six per cent of the
patients were either completely free of pain or had only mild barometric
discomfort postoperatively, and 88 per cent had markedly increased walking
ability after surgery. The majority of complications were related to
problems with soft-tissue healing. Postoperative stability to
anterior-posterior and valgus-varus stresses was obtained through a
combination of implant design and soft-tissue ligament balancing.