Total Knee Arthroplasty for Rheumatoid Arthritis with mild extra-articular femoral anterocurvatum deformity: A Case Report and Literature Review

Total knee arthroplasty (TKA) has achieved excellent outcomes through accurate bone resection and soft tissue balancing. TKA in patients with osteoarthritis (OA) or rheumatoid arthritis (RA) with extra-articular femoral deformity is technically difficult. Femoral deformity correction and TKA are often necessary in such cases.

A 63-year-old woman had also been diagnosed with RA 18 years earlier. Her RA was relatively well controlled. The patient presented with severe right knee pain and gait disturbance. The patient had femoral exostosis and underwent operative therapy (resection) 47 years earlier. Radiographic evaluation revealed Larsen grade 4 arthritis of the knee joint and 8° femoral anterocurvatum deformity, measured relative to the anatomical axis of the femur. Standard TKA was performed with intra-articular correction. An anterior femoral notch (AFN) with 5.4mm was identified intraoperatively. 12 months postoperatively, the symptoms disappeared. The anterior femoral notch depth decreased to 2.8mm.

Standard TKA with intra-articular correction can provide satisfactory clinical short-term outcomes in patients with mild extra-articular femoral anterocurvatum deformity when appropriate preoperative planning and surgical technique are applied.