抄録
Objective: Total elbow arthroplasty (TEA) is a recognized procedure for the treatment of the painful arthritic elbow. We studied the clinical long-term results of TEAs in patients with rheumatoid arthritis.
Methods: Between 1993 and 1999, 21 elbows were replaced using Kudo Type-5 prostheses. In total, 4 humeral components and 17 ulnar components were fixed with cement, and 14 humeral components and 1 ulnar component were fixed without cement. Perioperative complications, changes in clinical symptoms, radiographic changes, and survival rates were assessed for an average of 11.9 years.
Results: Intraoperative fracture of the medial epicondyle occurred in two patients. These patients had exhibited neurapraxia of the ulnar nerve. One elbow was dislocated and immobilized with a brace. The mean arc of flexion/extension was 99° (66° at the preoperative examination) and supination/pronation was 127° (98° at the preoperative examination). Radiological loosening assessment was conducted using standard anteroposterior and lateral views. Three ulnar components had global radiolucent lines suggestive of loosening. The results of Kaplan-Meier survivorship in patients with loosening were 100% at 5 years after operation and 83% at 10 years.
Conclusion: Kudo Type-5 TEAs provide good pain relief in the arthritic elbow leading to high patient satisfaction and long-term survivorship.
