Tashjian Robert Z, Wolf Jennifer M, Ritter Mark, Weiss Arnold-Peter, Green Andrew
Department of Orthopaedic Surgery, Brown Medical School/Rhode Island Hospital, Providence, RI, USA.
J Shoulder Elbow Surg. 2006 May-Jun;15(3):357-66. doi: 10.1016/j.jse.2005.08.004.
Ulnohumeral arthroplasty (UHA) is considered a satisfactory surgical treatment option for patients with primary degenerative arthritis of the elbow. Most series have used categoric elbow scoring systems to evaluate the outcome of this procedure. The purpose of our study was to evaluate the outcome of UHA with patient-derived functional and general health status outcome instruments. We evaluated 17 patients (18 elbows) with primary degenerative arthritis of the elbow at a mean of 85 months after UHA. The mean age at the time of surgery was 42 years (range, 26 to 58 years). At the follow-up evaluation, the patients were assessed with a physical examination, outcome assessment tools, and plain radiographs. The mean elbow flexion arc improved by 16 degrees (range, -15 degrees to 60 degrees ; P = .012), and the mean forearm rotation arc (supination/pronation) improved by 35 degrees (range, -20 degrees to 90 degrees ; P < .001). Of the elbows, 11 were painless, 4 were painful with motion, and 3 were painful at rest and with motion. The mean Hospital for Special Surgery elbow score was 70 (range, 40 to 99), and the mean Mayo Elbow Performance Score was 83 (range, 50 to 100). The mean Disabilities of the Arm, Shoulder and Hand score was 9.75 (range, 0 to 43.48). The Short Form-36 scores were better than the mean age- and sex-adjusted normal values. Patient self-assessed outcomes and general health status after UHA for primary degenerative elbow arthritis appear to be better than those determined by some categoric scoring systems. Consequently, the clinical utility of UHA may be underrepresented if physician-derived categoric scoring systems are the only measures of outcome assessment.
尺肱关节置换术（UHA）被认为是原发性肘关节退行性关节炎患者令人满意的手术治疗选择。大多数系列研究使用分类肘关节评分系统来评估该手术的结果。我们研究的目的是使用患者自评的功能和总体健康状况评估工具来评估UHA的结果。我们评估了17例（18个肘关节）原发性肘关节退行性关节炎患者，平均随访时间为UHA术后85个月。手术时的平均年龄为42岁（范围26至58岁）。在随访评估中，对患者进行了体格检查、结果评估工具和X线平片检查。平均肘关节屈曲弧度改善了16度（范围-15度至60度；P = 0.012），平均前臂旋转弧度（旋前/旋后）改善了35度（范围-20度至90度；P < 0.001）。在这些肘关节中，11个无痛，4个运动时疼痛，3个休息和运动时均疼痛。特殊外科医院肘关节平均评分为70分（范围40至99分），梅奥肘关节功能评分平均为83分（范围50至100分）。手臂、肩部和手部功能障碍平均评分为9.75分（范围0至43.4分）。简明健康状况调查简表（Short Form-36）评分优于按年龄和性别调整后的平均正常值。对于原发性退行性肘关节关节炎，UHA术后患者的自我评估结果和总体健康状况似乎优于某些分类评分系统所确定的结果。因此，如果仅以医生制定的分类评分系统作为结果评估的唯一指标，UHA的临床效用可能被低估。
