Weiland A J, Weiss A P, Wills R P, Moore J R
Department of Orthopaedic Surgery, Johns Hopkins University, School of Medicine, Baltimore, Maryland 21205.
J Bone Joint Surg Am. 1989 Feb;71(2):217-22.
The results of forty total elbow replacements in which a capitellocondylar prosthesis was implanted in thirty-five patients (five of whom had a bilateral procedure) were reviewed retrospectively. The average length of follow-up was 7.2 years (range, four to twelve years). Pronation, supination, and flexion of the elbow improved considerably, but extension did not change a great deal. The average rating of the elbow, according to the scoring system of Ewald et al., improved from 30 to 88 points, but the functional score, as defined by the American Rheumatism Association, improved in only four patients. Malarticulation or dislocation of the prosthesis occurred in ten patients (29 per cent). In two other patients, a deep infection developed, necessitating removal of the prosthesis. Ten prostheses (ten patients) had radiolucent lines on follow-up radiographs, but these lines were not associated with pain or loosening. Seven patients (seven elbows) had a transient ulnar-nerve palsy. The incidence of this complication was reduced from 30 per cent (five of seventeen patients) to 15 per cent (four of twenty-eight patients) when the lateral Kocher approach to the elbow was adopted.
回顾性分析了40例全肘关节置换术的结果，其中35例患者植入了髁间假体（5例为双侧手术）。平均随访时间为7.2年（范围4至12年）。肘关节的旋前、旋后和屈曲功能有显著改善，但伸展功能变化不大。根据Ewald等人的评分系统，肘关节的平均评分从30分提高到88分，但按照美国风湿病协会定义的功能评分仅在4例患者中得到改善。10例患者（29%）发生了假体排列不齐或脱位。另外2例患者发生深部感染，需要取出假体。10个假体（10例患者）在随访X线片上有透亮线，但这些线与疼痛或松动无关。7例患者（7个肘关节）出现短暂性尺神经麻痹。采用肘关节外侧Kocher入路时，该并发症的发生率从30%（17例患者中的5例）降至15%（28例患者中的4例）。
