Service d'orthopédie-traumatologie, urgences-main, centre hospitalier universitaire Toulouse-Purpan, place du Dr-Baylac, 31059 Toulouse, France.
Orthop Traumatol Surg Res. 2013 Oct;99(6 Suppl):S337-43. doi: 10.1016/j.otsr.2013.07.002. Epub 2013 Aug 9.
Few series have evaluated the long-term results of total elbow arthroplasty (TEA).
Fifteen patients with a Coonrad/Morrey total elbow implant were reviewed with a minimum follow-up of 10 years. There were nine women and six men with a mean age of 55 years at surgery. The aetiology was rheumatoid arthritis in eight cases, post-traumatic arthritis in five, psoriatic arthritis in one, and sequelae of neonatal septic arthritis in one. The TEA was performed as primary surgery in ten cases and during a revision surgery in four.
At 136 months average follow-up (120-160), MEPS was 82 ± 14 points (range 60-100) with a Quick DASH score of 41 points (range 13-83). Fourteen patients had no or slight pain and six had a functional range of motion. Elbow function was normal in eight of 15 patients. Radiolucent lines were found around the humerus in six cases (all of them incomplete) and around the ulnar component in eight (five of them complete) with loosening and migration of the ulnar stem occurring in two cases. Wear of the bushings was moderate in five cases and severe in two. There were ten complications with a revision needed in three cases. Revision-free survival rate for the implant was 100% at 5 years and 90% at 10 and 13 years.
The Coonrad/Morrey total elbow gives long-term satisfactory results. Increased incidence of radiolucent lines around the ulnar stem and bushing wear with longer follow-up is of concern and represents the failure mode for this total elbow arthroplasty implant.
IV.
很少有研究评估全肘关节置换术(TEA)的长期结果。
回顾了 15 例接受 Coonrad/Morrey 全肘假体的患者,随访时间至少为 10 年。9 例为女性,6 例为男性,手术时平均年龄为 55 岁。病因包括 8 例类风湿关节炎、5 例创伤后关节炎、1 例银屑病关节炎和 1 例新生儿脓毒性关节炎后遗症。TEA 在 10 例中作为初次手术,在 4 例中作为翻修手术。
在 136 个月的平均随访(120-160)时,MEPS 为 82±14 分(60-100 分),Quick DASH 评分为 41 分(13-83 分)。14 例患者无或轻度疼痛,6 例患者有功能活动范围。15 例患者中,8 例肘关节功能正常。6 例肱骨侧出现完全或不完全透亮线,8 例尺骨侧出现透亮线,其中 5 例完全透亮线,2 例尺骨柄松动、迁移。5 例衬套磨损中度,2 例磨损严重。有 10 例并发症,其中 3 例需要翻修。在 5 年、10 年和 13 年时,植入物的无翻修生存率为 100%。
Coonrad/Morrey 全肘假体可获得长期满意的结果。随着随访时间的延长,尺骨柄周围和衬套磨损的透亮线发生率增加令人担忧,这代表了这种全肘置换假体的失效模式。
IV 级。