Larson A N, Adams R A, Morrey B F
Department of Orthopaedic Surgery, University of Minnesota, 2512 South 7th Street, Minneapolis, MN 55454, USA.
J Bone Joint Surg Br. 2010 Sep;92(9):1273-7. doi: 10.1302/0301-620X.92B9.24039.
Between 1996 and 2008, nine patients with severe post-traumatic arthritis underwent revision of a failed interposition arthroplasty of the elbow with a further interposition procedure using an allograft of tendo Achillis at a mean of 5.6 years (0.7 to 13.1) after the initial procedure. There were eight men and one woman with a mean age of 47 years (36 to 56). The mean follow-up was 4.7 years (2 to 8). The mean Mayo Elbow Performance score improved from 49 (15 to 65) pre-operatively to 73 (55 to 95) (p = 0.04). The mean Disability of the Arm, Shoulder and Hand score was 26 (7 to 42). One patient was unavailable for clinical follow-up and one underwent total elbow replacement three months post-operatively. Of the remaining patients, one had an excellent, two had good, three fair and one a poor result. Subjectively, five of the nine patients were satisfied. Four continued manual labour. Revision interposition arthroplasty is an option for young, active patients with severe post-traumatic arthritis who require both mobility and durability of the elbow.
1996年至2008年间,9例严重创伤后关节炎患者接受了肘关节间置关节成形术失败后的翻修手术,在初次手术后平均5.6年(0.7至13.1年)采用跟腱同种异体移植进行了进一步的间置手术。其中有8名男性和1名女性,平均年龄47岁(36至56岁)。平均随访时间为4.7年(2至8年)。Mayo肘关节功能评分平均从术前的49分(15至65分)提高到73分(55至95分)(p = 0.04)。上肢、肩部和手部功能障碍评分平均为26分(7至42分)。1例患者无法进行临床随访,1例患者在术后3个月接受了全肘关节置换术。其余患者中,1例结果为优,2例为良,3例为中,1例为差。主观上,9例患者中有5例感到满意。4例继续从事体力劳动。翻修间置关节成形术是年轻、活跃的严重创伤后关节炎患者的一种选择,这些患者需要肘关节的活动度和耐用性。