Benefits of a New Knee Joint for Children with Rheumatoid ArthritisKnee joint replacements aren't just for adults. Children with rheumatoid arthritis can have disabling knee problems. A joint replacement may be a good treatment option. This option is so good, some children have both knees replaced.
A study from the Mayo Clinic in Rochester, Minnesota, reports the results of knee replacements in children. Twenty-five knees were replaced in 13 children with rheumatoid arthritis. The patients were all under the age of 20.
Doctors don't usually recommend knee implants for children. They're concerned that the implant won't last. They don't want children to have multiple operations before mid-life. Things are changing, though, because many studies show good results (in adults) with today's modern knee replacements.
The authors of this study looked at pain and function as measures of success. Before the operation, some of the children couldn't even walk, while others could only walk indoors or for short distances outside. After surgery, only one patient had to use a wheelchair. All others could walk varying distances.
Pain was lower after the knee replacement, but range of motion was not restored. The loss of motion caused many other problems. The doctors think this is true because the soft tissues around the joint are also affected by the arthritis. They may have become too damaged for the joint replacement to help.
The authors conclude that joint replacement is an option for children with rheumatoid arthritis. They advise trying to save the joint first with every other treatment possible. Parents and patients can expect less pain and improved quality of life, but motion may not be restored.
Javad Parvizi, MD, et al. Total Knee Arthroplasty in Young Patients with Juvenile Rheumatoid Arthritis. In The Journal of Bone and Joint Surgery. June 2003. Vol. 85-A. No. 6. Pp. 1090-1094.
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