van der Lugt J C T, Rozing P M
Department of Orthopaedic Surgery, Leiden University Medical Center, Leiden, The Netherlands.
J Shoulder Elbow Surg. 2006 Mar-Apr;15(2):208-14. doi: 10.1016/j.jse.2005.07.009.
Total elbow arthroplasty is used for the treatment of the painful, destroyed elbow joint. With the increase in elbow replacement surgery in recent years, the number of revision surgeries will also increase. At our center, 236 primary Souter-Strathclyde total elbow prostheses have been placed. Twenty-four of these have been revised and were followed up for a mean of 74 months (range, 12-165 months). The postoperative clinical outcome after revision surgery can approximate the outcome after primary elbow replacement. Unfortunately, 8 elbows needed to be re-revised, 7 elbow prostheses loosened, and we had 1 early dislocation during follow-up. Three of the eight re-revised elbows had a third revision. Two other patients had a resection arthroplasty because of deep infection after the first revision. After 5 years, 73.8% of the revised elbow prostheses were still in situ. The lack of other satisfactory treatment options, combined with the satisfactory clinical results, justify revision surgery of elbow prostheses. The absence of intraoperative fracture during removal of the relatively small standard components and the availability of long-stemmed revision components, which facilitate fixation in the impaired bone, both support our preference for the Souter-Strathclyde prosthesis.
全肘关节置换术用于治疗疼痛、毁损的肘关节。近年来随着肘关节置换手术的增加，翻修手术的数量也会增加。在我们中心，已植入236例原发性Souter-Strathclyde全肘关节假体。其中24例进行了翻修，并进行了平均74个月（范围12 - 165个月）的随访。翻修手术后的临床结果可接近初次肘关节置换后的结果。不幸的是，随访期间有8例肘关节需要再次翻修，7例肘关节假体松动，还有1例早期脱位。8例再次翻修的肘关节中有3例进行了第三次翻修。另外2例患者因初次翻修后深部感染而行切除性关节成形术。5年后仍有73.8%的翻修肘关节假体在位。由于缺乏其他令人满意的治疗选择，再加上临床结果令人满意，使得肘关节假体翻修手术具有合理性。在取出相对较小的标准组件时未发生术中骨折，以及有便于固定于受损骨质的长柄翻修组件，这两点都支持我们对Souter-Strathclyde假体的偏爱。
