Series related to other inflammatory arthropathies are uncommon. The AOANJRR reports that there is no difference in implant survival between OA and seronegative arthropathy [45]. Parvizi et al. [57] in 2001 published a series of 33 TKAs in patients with AS at a mean of 11.2 years following surgery. They reported excellent pain relief and only one revision (of a loose patellar component), but a high rate of heterotopic bone formation (6/33 knees, 20 %) and stiffness, with three patients requiring manipulation under anaesthetic. Stern et al. [58] in 1989 retrospectively reviewed 27 TKAs (in 18 patients) in patients with psoriasis at a single institution. They reported a high rate of deep infection (4/24 patients, 17 %) and of revision (21 % at 4 years). However, the inclusion criteria were broad – the authors do not classify any patient as having PA, but suggest that the patients had coexistent RA/OA and psoriasis – and all patients had active skin lesions at the time of surgery.

TKA in the presence of inflammatory arthropathy presents distinct challenges compared to cases with osteoarthritis (OA). Preoperative planning is of paramount importance to avoid anaesthetic and surgical complications, which are more prevalent in patients with inflammatory disease. Patients with RA may present with large amounts of bone loss, and soft tissue instability is often a major feature. As a result, posterior-stabilised designs are often preferred in rheumatoid arthritis (RA), as is patellar resurfacing (although the evidence for both conventions is limited). Patients with RA are at increased risk of infection and complications in general following TKA than those with OA. Overall survival appears to be similar in RA compared to OA. Patients with inflammatory arthropathy can benefit greatly from TKA, attaining excellent outcomes in terms of implant survival and post-operative function.