RA

Question 1

what are the surgical options for RA of the knee?

Answer 1

• synovectomy and debridement -> failed medical treatment (perform via arthroscopically and remove articular pannus and cartilage)
• supracondylar osteotomy -> use when knee is stable and pain free but complicated by valgus and flexion deformity
• total knee arthroplasty -> advanced jt destruction

Question 2

Clinical features of RA of the knee

Answer 2

stage 1 - proliferative

• palpable effusions and thickened synovium but stable joint
• posterior capsule at risk of rupture
• acute rupture of baker’s cyst

stage 2 - destructive

• increase instability of knee joint
• marked muscle wasting
• some loss of flexion and extension

stage 3 - reparative:

• severe pain and instability -> marked stiffness/ severe instability
• common deformities are fixed flexion and valgus
• instability manifests as increased anteroposterior glide and lateral wobble