抄録
Debridement and radial head replacement with a silicon rubber implant was carried out on 32 elbows in 24 rheumatoid patients, 17 women and 7 men, aged from 29 to 73 years between 1975 and 1983. The mean duration of rheumatoid arthritis was 13.4 years. The period of follow-up was 6.2 years on an average. The assessment was made on the basis of objective, subjective and radiological criteria. Radiological assessment of the joints was made using the modified criteria of Steinbrocker.
In these 32 joints, 15 were rated poor (group A) . Six had experienced breakage, 6 loosening, 2 anterior subluxation of radius and one malalignment of the implant. Seventeen joints were rated good (group B) .
The range of motion of both groups was almost the same. A slight pain on motion was found in 9 joints in group A (60%) and in 3 joints in group B (19%) . Six joints in group A showed a slight medio-lateral instability while none did in group B. The degree of joint destruction at surgery was higher in group A. In spite of poor X-ray findings, all joints in group A functioned well for an average daily activities.
It is suggested that radial head replacement with a silicon rubber implant seems to be more valuable in treating rheumatoid elbows with less severe joint destruction.
