Two-steps surgical restoration of the function of ankylosing knee joint in rheumatoid arthritis

Two-steps restoration of knee joint function enables first to eliminate the flexion deformity by mobilization and then gradually to elongate the posterior anatomic structures of fibrous ankylosing knee joint. For the management the hinged distraction apparatus is used. In bone flexion ankylosis of the knee joint the osteotomy is performed along the line of the union of femur with the patella and tibia followed by gradual extension of the knee joint using hinged distraction apparatus. During the second step of the surgery the restoration of the whole synovial space of the knee joint including the articular cartillage is achieved. Conception of the articular cartillage restoration has been based and formulated and the leading role is given to arthroplasty using preserved costal cartillage in complex with the irrigation of knee joint through the drain loop. This two-steps procedure preserves the relation-ship of articular surfaces at most and enables to achieve functional and weightbearing knee joint. Long term results of the surgical treatment of 35 ankylosing knee joints in 28 patients with rheumatoid arthritis are presented. The dependence of treatment efficacy on the patient’s age and type of ankylosis is detected. Efficiency of the treatment ranged from 22,8% to 26,2%.