Department of Orthopaedic Surgery, University of Leuven, Pellenberg, Belgium.
J Shoulder Elbow Surg. 2013 Nov;22(11):1455-60. doi: 10.1016/j.jse.2013.06.013. Epub 2013 Sep 3.
The purpose of this study is to review the long term results the Kudo and instrumented Bone Preserving elbow prostheses. The instrumented Bone Preserving prosthesis is the successor of the Kudo prosthesis, and both of these are nonconstrained elbow resurfacing prostheses.
Fifty-five nonconstrained elbow prosthesis were implanted in 51 patients. Patients were evaluated with the Mayo Elbow Performance Score (MEPS) and Disabilities of the Arm Shoulder and Hand score. Revision or the necessity of revision was regarded as failure of the prosthesis.
Twenty-one prostheses (of which 3 instrumented Bone Preserving prostheses) were revised or needed revision, yielding a revision rate of 15.1% after 5 years and 36.5% after 10. The major reasons for revision were loosening in 10 cases and instability in 5. Eleven of the nonrevised patients died of unrelated causes, having little or no subjective problems until the time of death. There was no statistical difference between Kudo and instrument Bone Preserving implant survival. Most nonrevised patients were satisfied, according to the Visual Analog Scale for satisfaction. The median MEPS indicated fair to good results.
When comparing our results to those of other elbow prosthesis we must conclude that our revision rate is high, however, the outcome of the nonrevised patients is good. This study shows that the results of the Kudo prosthesis, which have been reported twice before by our department, have clearly deteriorated after an average follow-up of 174 months (the last study had an average follow-up of 58 months).
本研究旨在回顾 Kudo 和Instrumented Bone Preserving 肘假体的长期结果。Instrumented Bone Preserving 假体是 Kudo 假体的继承者,两者均为非约束性肘表面置换假体。
51 例患者共植入 55 个非约束性肘假体。采用 Mayo 肘功能评分(MEPS)和上肢功能障碍评分(DASH)对患者进行评估。将假体的翻修或需要翻修视为假体失败。
21 个假体(其中 3 个为 Instrumented Bone Preserving 假体)需要翻修,术后 5 年的翻修率为 15.1%,术后 10 年的翻修率为 36.5%。翻修的主要原因是 10 例假体松动和 5 例假体不稳定。11 例未翻修的患者因非相关原因死亡,在死亡前几乎没有或没有主观问题。Kudo 和 Instrumented Bone Preserving 假体的存活率无统计学差异。根据满意度视觉模拟量表,大多数未翻修的患者对假体感到满意。MEPS 中位数表明结果为良好至较好。
与其他肘假体的结果相比,我们的翻修率较高,但未翻修患者的结果良好。本研究表明,我们科室之前两次报道的 Kudo 假体结果在平均随访 174 个月(最后一次研究的平均随访时间为 58 个月)后明显恶化。