日本リウマチ・関節外科学会雑誌
Online ISSN : 1884-9059
Print ISSN : 0287-3214
ISSN-L : 0287-3214
関節リウマチに対する非拘束型人工肘関節の治療成績
瀬尾 健一河村 誠一今澤 良精佐々木 伸一津嶋 秀俊
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2007 年 26 巻 1 号 p. 35-40

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Objective: The purpose of this study was to assess the short-term results of non-constrained total elbow arthroplasty in patients with rheumatoid arthritis (RA) .
Methods: Nine elbows in eight patients were followed up for this study. Prior to surgery, the elbows were graded 4 or 5 according to Larsen radiological criteria. The patients were followed up for an average of 15.8 months (range: 5 months to 2 years 8 months) . According to Kudos category, seven elbows had painful instability, and two had painful stiffness.
Results: The results, assessed according to the scoring system of the Japanese Orthopaedic Association, revealed remarkable improvement in pain and daily activities. Average rating of the elbows improved from 37.2 to 77.3 points. The average range of flexion was increased by 17.0 degrees (from 114.4 to 131.4 degrees), but the average of extension was decreased by 11.5 degrees (from -35.7 to -47.2 degrees) . In one patient there was subluxation with pain and instability.
Conclusion: Total elbow arthroplasty may give good results in terms of relief of pain, mobility, and stability.In our experience, the average range of flexion was increased by 17.0 degrees (from 114.4 to 131.4 degrees), and this gain was significant. We would like to emphasize that the use of a non-constrained prosthesis necessitates greater attention to the operative technique, including insertion of components and repair of soft tissue balance. In conclusion, total elbow arthroplasty is considered to be a valuable procedure for restoring daily life activities of patients with rheumatoid arthritis.

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