Total Knee Arthroplasty in Ankylosed Knees

OBJECTIVE To evaluate the results of results of total knee replacement (TKA) in stiff and Ankylosed knees. A retrospective study was done to evaluate the results of total knee arthroplasty performed on 110 knees in 69 patients with spontaneously Ankylosed knees. The reasons of ankylosis was previous infection (pyogenic and tuberculous), inflammatory arthritis (rheumatoid arthritis, Juvenile rheumatoid arthritis, ankylosing spondylitis) and post –traumatic. The age at operation ranged from 30 to 65 years (average 42.8 years). Preoperative arc of movement was between 0 degrees and 20 degrees (average, 14 degrees). The difficulties encountered in surgical exposure were managed by using various extensile exposure techniques. Quadriceps snip was used in all case to avoid patellar avulsion. Follow-up ranged from 5 to 17 years (average, 9 years). The average postoperative arc of movement at final follow-up was 75.8 degrees, with a significant average gain of 61 degrees at final follow up. The average preoperative Hospital for Special Surgery Knee Score was 60 which improved to 75 at the final follow up. The average extensor lag was 8 degrees (range 0- 20 degrees). Complications included skin edge necrosis (35%), pyogenic infection in 3 patients, and a quadriceps tendon rupture in 1 patient. 4 knees were revised on account of component loosening. Conclusions Total knee arthroplasty in Ankylosed knees does achieve correction of deformity with gain in range of motion leading to improved quality of life. Meticulous surgical technique is required to prevent complications. We believe that TKA in Ankylosed knees is a viable option.