Successful Staged Bilateral Hip and Knee Arthroplasty in a Patient with Long-standing Rheumatoid Arthritis with Severe Deformities

Sep 29, 2026

Upload by hdkawk

Rheumatoid arthritis is a chronic autoimmune disorder that commonly drives progressive joint destruction, complex deformities, and systemic complications. This case report describes a 39-year-old woman with a 15-year history of RA, severe bilateral hip and knee deformities, flexion contractures, end-stage arthropathy, and preoperative anemia and osteoporosis. A multidisciplinary plan enabled successful staged bilateral total hip and knee arthroplasty, including robotic-assisted left hip replacement, with uneventful recovery and independent, pain-free ambulation.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages6

Reading Time15 min

AccessFree to download

Learning Point of the Article

Abstract

Introduction

Case Report

Conclusion

Keywords

Introduction

Case Report Journal of Orthopaedic Case Reports 2025 December:15( 12) :Page 247-252 Successful Staged Bilateral Hip and Knee Arthroplasty in a Patient with Long-standing Rheumatoid Arthritis with Severe Deformities Gaurav Gupta1, Akshay Ramesh Gupta1, ShubhamAggarwal1 Learning Point of the Article: Bilateral joint arthroplasty is a practical treatment approach for young patients with severe rheumatoid arthritis and intricate deformities. Prioritizing early planning, fostering multidisciplinary care, and incorporating robotic assistance can greatly enhance surgical accuracy, safety, and functional recovery in these high-risk situations. Abstract Introduction: Rheumatoid arthritis (RA) is a chronic autoimmune condition that frequently results in serious joint deformities, reduced function, and systemic issues. Complicated deformities in major joints such as the hips and knees create considerable management difficulties, particularly when aggravated by osteoporosis and anemia. Case Report: Wereporta 39-year-oldwoman with a 15-year history of RAwho has severebilateral deformities in her hipsand knees. She could not ambulate independently due to advanced joint destruction, chronic flexion contractures, and functional disability. Pre-operative imaging confirmed end-stage arthropathy, and laboratory workup showed severe anemia and osteoporosis. A multidisciplinary approach led to successful staged bilateral total hip and knee arthroplasty, including robotic-assisted left hip replacement. Post-operative recovery was uneventful, enabling the patient to ambulate independently and restore jointmobility pain-free. Conclusion: This case demonstrates the success of a staged, multidisciplinary strategy for addressing intricate bilateral joint deformities resulting from RA. The use of robotic assistance along with thorough perioperative planning can enhance surgical precision and support functional recovery, even for high-risk patients. Keywords: Rheumatoid arthritis, total joint arthroplasty, flexion deformity, bilateral hip and knee replacement, osteoporosis, robotic hip replacement, staged surgery, functional recovery. Introduction Rheumatoid arthritis (RA) is a systemic autoimmune disorder predominantly affecting the joints, presenting a range of clinical manifestations. Pain and stiffness frequently increase after periods of inactivity. The wrists and hands are most commonly affected, typically on both sides of the body. The condition can also influence other body areas, potentially causing a low red blood cell count, lung inflammation, and heart inflammation. Its progression is marked by joint inflammation, pain, and stiffness, potentially impacting multiple organ systems. Symptoms such as fever and low energy may also occur and usually develop gradually over weeks or months. Recognizing these clinical manifestations is essential for prompt diagnosis and the application of effective management strategies [1, 2, 3]. The primary characteristic of RA is synovitis, the synovial |
Access this article online

Website: [www.jocr.co.in](www.jocr.co.in)

DOI:
[https://doi.org/10.13107/jocr.2025.v15.i12.6524](https://doi.org/10.13107/jocr.2025.v15.i12.6524) | Author’s Photo Gallery | | | | --- | --- | --- | --- | | | | | | | | Dr. Gaurav Gupta ~~ ~~ Dr. ShubhamAggarwal

1Department of Orthopaedics, Max Superspeciality Hospital, Dehradun, Uttarakhand, India.
Address of Correspondence:
Dr. Gaurav Gupta,
Department of Orthopaedics, Max Superspeciality Hospital, Dehradun, Uttarakhand, India. [E-mail:](E-mail: drgauravorthosurgeon@gmail.com)[ drgauravorthosurgeon@gmail.com](E-mail: drgauravorthosurgeon@gmail.com) | | | | Submitted: 27/09/2025; Review: 28/10/2025; Accepted: November 2025; Published: December 2025 | | | | | DOI: [https://doi.org/10.13107/jocr.2025.v15.i12.6524](https://doi.org/10.13107/jocr.2025.v15.i12.6524)
© The Author(s). 2025 Open Access. This article

FAQs

What makes staged bilateral arthroplasty a practical option in long-standing rheumatoid arthritis?

The article highlights that bilateral joint arthroplasty is practical for young patients with severe rheumatoid arthritis and intricate deformities when early planning and multidisciplinary care are prioritized.

What were the key preoperative findings in the reported patient?

Pre-operative imaging confirmed end-stage arthropathy, and laboratory evaluation showed severe anemia and osteoporosis, alongside advanced bilateral hip and knee deformities with chronic flexion contractures.

How did the patient recover after the staged surgeries?

Post-operative recovery was uneventful, allowing the patient to ambulate independently and restore joint mobility without pain.

Sep 29, 2026

Upload by hdkawk