The knee joint is commonly damaged in polyarticular rheumatoid arthritis. Surgical management depends on the preservation of the articular cartilage and degree of synovitis. Arthroscopic synovectomy is performed in intractable synovitis with cartilage sparing. Technique of total knee replacement is more complex because of bone and soft-tissue damage in rheumatoid arthritis, and complications are more common, particularly infection. Overall, long-term results with knee arthroplasty have been excellent in rheumatoid arthritis, with improved function and reduction in pain in the vast majority of patients.
