Abstract
In rheumatoid arthritis, the joints of the lower extremities are almost always affected. This is most conspicuous in the knee joint. In rheumatics, inflammatory osteoarthritis manifests itself comparably earlier than in patients with osteoarthritis. The focus of attention was primarily on the synovia with its destruction process and secondary changes. Now, driven by experimental research, dendritic cells and fibroblasts and molecular features are moving into the clinician’s field of vision. Even in joints that appear to be in remission with no swelling or pain, the activity of these cells leads to changes in the capsule-ligaments. The complex deformities and instabilities caused by this, in conjunction with atrophy of the inter-articular musculature, have an impact on the activities of daily life (ADL). If these biomechanical aspects of the knee joint are not taken into account early on in therapy, the frequency of primary and secondary surgical treatment increases. The timely recognition of biomechanical pathologies and consistent treatment can contribute to improving the patient situation in addition to adequate medication therapy.
Highlights
Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that affects the knee joints in over 90% of patients
A concept for the therapy of rheumatoid knee joint manifestations must take into account conservative and surgical treatment of the knee joint according to the stage of the disease and take into account the individual characteristics of the patient [6,7]
Generalized existing autoantibodies, such as anti-citrullinated protein antibodies (ACPA) and cytokines maintain the production of inflammatory mediators in addition to synovial fibroblasts and lead to oxidative stress
Summary
Rheumatoid arthritis (RA) is an inflammatory autoimmune disease that affects the knee joints in over 90% of patients. Sci. 2020, 10, 8600 possible [2,3,4] This leads to a significant reduction in inflammatory activity and more patients achieve remission. A concept for the therapy of rheumatoid knee joint manifestations must take into account conservative and surgical treatment of the knee joint according to the stage of the disease and take into account the individual characteristics of the patient [6,7]. Following an overview of the pathogenesis of RA in the joint, the article describes the biomechanical changes and peculiarities of the rheumatoid knee and provides a current summary of conservative and operative therapy. From an initial total of more than 22,000 articles, up to 65 were left, of which up to 37 were included in this manuscript [9]
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