[Clinical studies and postoperative results of 51 nonambulatory rheumatoid patients with total joint replacements].

Between October 1971 and June 1984, total joint replacement was performed on 51 nonambulatory patients with rheumatoid arthritis (RA). These nonambulatory patients showed high RA activity, and many presented with extra-articular symptoms with reference to the heart, lung, etc. During follow-up, 13 patients died of diseases unrelated to the operation, and the whereabouts of other 3 patients were unknown. Thus, the total joint replacement was evaluated in the remaining 35 patients. The walking ability was improved in 27 patients. However, the hoped-for results were not attained in relation to various aspects of the activities of daily life. Complications developed in 6 joints of 6 patients. The factors responsible for poor results were loss of motivation, muscle weakness, reduced function of the upper extremities, osteoporosis, cervical spinal cord injury, etc. From these results, it is emphasized that properly-timed surgery at the right level can prevent RA patient from becoming nonambulatory.