Department of Orthopaedic Surgery, Daejeon St. Mary's Hospital, The Catholic University Medical College, Seoul, South Korea.
J Shoulder Elbow Surg. 2013 Aug;22(8):1121-7. doi: 10.1016/j.jse.2013.03.003. Epub 2013 May 8.
This study evaluates the long-term results, including complication and revision rates, of different types of total elbow arthroplasty (TEA) with an average follow up of 13 years.
Since 1984, a total of 84 primary TEAs have been performed in 77 patients at our institution. The patient's average age was 54.2 years. We performed unlinked TEA in 35 cases (Pritchard ERS since 1984 [n = 18], Kudo type 3 since 1991 [n = 17]), and semi-linked TEA in 49 cases (Pritchard Mark II since 1997 [n = 14], Coonrad-Morrey since 2001 [n = 35]). We assessed the patients for compliance to daily living guidelines (not to exceed 2.25 kg for repetitive lifting and 4.5 kg for single episode lifting), and followed up with them for an average of 13 years after primary TEA. We analyzed their results with regard to complication and revision rates as the type of TEA.
The mean Mayo Elbow Performance Score (MEPS) improved from preoperative 34 points to postoperative 84 points. The active flexion-extension elbow motion increased from 25°-94° preoperative to 12°-130° postoperative. The overall complication rate was 44.0% (37/84 cases); the rate was statistically higher in the unlinked group (62.9%, 22/35 cases) than in the semi-linked group (30.6%, 15/49 cases). The overall revision rate was 27.4% (23/84 cases); the rate was higher in the unlinked group (34.3%, 12/35 cases) than in the semi-linked group (22.4%, 11/49 cases).
Semi-linked TEA has better outcomes than unlinked TEA with respect to complication and revision rates; but continuous efforts to develop a new TEA design for longevity, improved cementing technique, and supporting activities of daily living are needed to reduce complication and revision rates in the future.
本研究评估了不同类型全肘关节置换术（TEA）的长期结果，包括并发症和翻修率，平均随访时间为 13 年。
自 1984 年以来，我们机构共对 77 名患者的 84 例原发性 TEA 进行了手术。患者的平均年龄为 54.2 岁。我们进行了非连接 TEA 35 例（自 1984 年以来的 Pritchard ERS[n=18]，自 1991 年以来的 Kudo 型 3[n=17]），半连接 TEA 49 例（自 1997 年以来的 Pritchard Mark II[n=14]，自 2001 年以来的 Coonrad-Morrey[n=35]）。我们评估了患者对日常生活指南的遵守情况（重复性举重不超过 2.25 公斤，单次举重不超过 4.5 公斤），并在初次 TEA 后平均随访 13 年。我们根据 TEA 的类型分析了他们的并发症和翻修率结果。
平均 Mayo 肘功能评分（MEPS）从术前的 34 分提高到术后的 84 分。主动屈伸肘运动从术前的 25°-94°增加到术后的 12°-130°。总体并发症发生率为 44.0%（37/84 例）；非连接组（62.9%，22/35 例）的发生率明显高于半连接组（30.6%，15/49 例）。总的翻修率为 27.4%（23/84 例）；非连接组（34.3%，12/35 例）的发生率明显高于半连接组（22.4%，11/49 例）。
半连接 TEA 在并发症和翻修率方面的结果优于非连接 TEA；但需要不断努力开发新的 TEA 设计，以提高其使用寿命、改进骨水泥技术，并支持日常生活活动，以降低未来的并发症和翻修率。
