Viveen Jetske, Prkic Ante, Koenraadt Koen L M, Kodde Izaäk F, The Bertram, Eygendaal Denise
Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands.
Upper Limb Unit, Department of Orthopaedic Surgery, Amphia Hospital, Breda, The Netherlands.
J Shoulder Elbow Surg. 2017 Apr;26(4):716-722. doi: 10.1016/j.jse.2016.10.010. Epub 2017 Jan 13.
The aim of this study is to report on the midterm outcomes and complications of revision surgery of total elbow arthroplasty.
All patients who had undergone total elbow arthroplasty revision surgery between 2009 and 2014 with semiconstrained total elbow prostheses were prospectively enrolled in the study. Records were reviewed for demographic data; baseline measurements; and several follow-up assessments including the Mayo Elbow Performance Score (MEPS), visual analog scale (VAS) score for pain, Oxford Elbow Score, range of motion, satisfaction, and radiographs.
A total of 19 revision arthroplasties were included. At a mean follow-up of 57 months, there had been 1 rerevision and 2 removals. One patient was excluded from follow-up because of confounding comorbidity. At last follow-up, MEPS values and VAS pain scores both improved (P < .01). The rate of combined good and excellent results on the MEPS was 53%. The mean VAS scores for pain at rest and with activity were 2 and 4, respectively. Fair results for the Oxford Elbow Score were reported, with a mean score of 28 points. Range of motion improved to an average flexion-extension arc of 108° (P < .01), and the pronation-supination arc improved to an average of 123° (P < .01). All elbows were stable at last follow-up (P < .01). Radiographs showed nonprogressive osteolysis around the prosthesis in 3 cases (19%) and suspicion of loosening in 1 (6%). In 11 patients postoperative complications occurred. Of 15 patients, 13 (87%) were satisfied with the result of the revision procedure.
Revision of total elbow prostheses leads to satisfactory results, less pain, and better elbow function. This procedure is related to a relatively high complication rate.
本研究旨在报告全肘关节置换翻修手术的中期结果及并发症。
前瞻性纳入2009年至2014年间接受半限制型全肘关节假体翻修手术的所有患者。回顾记录中的人口统计学数据、基线测量值以及包括梅奥肘关节功能评分（MEPS）、疼痛视觉模拟量表（VAS）评分、牛津肘关节评分、活动范围、满意度和X线片在内的多项随访评估结果。
共纳入19例翻修关节成形术。平均随访57个月时，有1例再次翻修和2例取出假体。1例患者因复杂的合并症被排除在随访之外。在最后一次随访时，MEPS值和VAS疼痛评分均有所改善（P < .01）。MEPS综合优良率为53%。静息和活动时的平均VAS疼痛评分分别为2分和4分。牛津肘关节评分结果为中等，平均分为28分。活动范围改善至平均屈伸弧为108°（P < .01），旋前-旋后弧改善至平均123°（P < .01）。在最后一次随访时所有肘关节均稳定（P < .01）。X线片显示3例（19%）假体周围有非进行性骨溶解，1例（6%）怀疑有松动。11例患者发生术后并发症。15例患者中，13例（87%）对翻修手术结果满意。
全肘关节假体翻修可取得满意的结果，疼痛减轻，肘关节功能改善。该手术的并发症发生率相对较高。
