Lerch K, Tingart M, Trail I, Grifka J
Klinik für Orthopädie, Universität Regensburg,Bayerisches Rheuma- und Orthopädie Zentrum des BRK, Bad Abbach, Germany.
Orthopade. 2003 Aug;32(8):730-5. doi: 10.1007/s00132-003-0526-y.
Total elbow arthroplasty has become a reliable treatment option for patients with rheumatoid arthritis as well as primary or posttraumatic arthrosis. The aim of this study is to present the indications, operative technique and results for the implantation of an Acclaim elbow prosthesis. Case reports are given to demonstrate the indications for prosthesis implantation. Furthermore, the follow-up results are reported for 65 patients after implantation of an Acclaim prosthesis. Pre- and postoperative pain were evaluated using the visual analogue scale. The pain level decreased from 8.0 to 2.3 postoperatively. After implantation of an elbow prosthesis, there was a significant improvement in the range of motion. The mean flexion increased from 103 degrees preoperatively to 140 degrees postoperatively. An increase of 10 degrees was found for both supination and pronation. Complications included temporary ulnary nerve irritation in seven patients, intraoperative fractures in four cases and postoperative elbow dislocation in one case. In conclusion, total elbow arthroplasty results in a reduction of pain and an improvement in elbow movement. However, selection of the right patient is important. Patients are advised not to lift heavy objects or to perform hard physical work. If patients' compliance can not be ensured preoperatively, no total elbow arthroplasty should be performed.
全肘关节置换术已成为类风湿性关节炎以及原发性或创伤后关节炎患者的一种可靠治疗选择。本研究的目的是介绍Acclaim肘关节假体植入的适应症、手术技术和结果。通过病例报告展示假体植入的适应症。此外，报告了65例植入Acclaim假体患者的随访结果。使用视觉模拟量表评估术前和术后疼痛。术后疼痛水平从8.0降至2.3。植入肘关节假体后，活动范围有显著改善。平均屈曲度从术前的103度增加到术后的140度。旋前和旋后均增加了10度。并发症包括7例患者出现暂时性尺神经刺激、4例术中骨折和1例术后肘关节脱位。总之，全肘关节置换术可减轻疼痛并改善肘关节活动。然而，选择合适的患者很重要。建议患者不要提重物或从事繁重的体力劳动。如果术前不能确保患者的依从性，则不应进行全肘关节置换术。
