Kim Hwan Jin, Kim Jung Youn, Kee Young Moon, Rhee Yong Girl
Shoulder & Elbow Clinic, Department of Orthopaedic Surgery, College of Medicine, Kyung Hee University, 1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702, Korea.
Department of Orthopaedic Surgery, Hangang Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Republic of Korea.
Int Orthop. 2018 Feb;42(2):367-374. doi: 10.1007/s00264-017-3704-y. Epub 2017 Dec 5.
To evaluate the clinical and radiographic outcomes of patients with total elbow arthroplasty (TEA) and soft tissue reconstruction.
We investigated six patients who underwent TEA and soft tissue reconstruction (two elbows with 1-stage surgery and four elbows with 2-stage surgery). The mean patient age at the time of the surgical procedure was 43.2 years; the mean follow-up duration was 88.2 months.
The mean pain visual analogue scale (VAS) during motion was improved from 6.3 pre-operatively to 0.7 at the last follow-up. The mean Mayo Elbow Performance Score (MEPS) improved from 26.7 pre-operatively to 81.7 at the last follow-up. The mean flexion-extension arcs of the 1- and 2-stage surgery groups increased from 12.5° and 13.8° pre-operatively to 72.5° and 100° at the last follow-up, respectively. The mean MEPS of the one and two stage surgery groups were 75 and 85, respectively, at the last follow-up. One of the six elbows had loosening on the simple radiograph at the last follow-up, and there were no cases with bushing wear. Three elbows needed additional skin debridement owing to wound complications (2/2 elbows in the 1-stage surgery group and 1/4 elbows in the 2-stage surgery group).
Under unfavorable soft tissue conditions, performing soft tissue reconstruction with TEA provides satisfactory functional improvement and pain relief. The two stage surgery provided a lower rate of wound complication and better elbow function than the one stage surgery, which led to high patient satisfaction post-operatively.
Therapeutic Level IV.
评估全肘关节置换术（TEA）及软组织重建患者的临床和影像学结果。
我们调查了6例行TEA及软组织重建的患者（2例肘关节为一期手术，4例肘关节为二期手术）。手术时患者的平均年龄为43.2岁；平均随访时间为88.2个月。
运动时疼痛视觉模拟量表（VAS）评分均值从术前的6.3改善至末次随访时的0.7。梅奥肘关节功能评分（MEPS）均值从术前的26.7提高至末次随访时的81.7。一期和二期手术组的平均屈伸弧分别从术前的12.5°和13.8°增加至末次随访时的72.5°和100°。末次随访时，一期和二期手术组的平均MEPS分别为75和85。6例肘关节中有1例在末次随访时X线片显示松动，无衬套磨损病例。3例肘关节因伤口并发症需要额外的皮肤清创术（一期手术组2/2例肘关节，二期手术组1/4例肘关节）。
在软组织条件不佳的情况下，行TEA并进行软组织重建可带来满意的功能改善和疼痛缓解。与一期手术相比，二期手术的伤口并发症发生率更低，肘关节功能更好，术后患者满意度高。
治疗性四级。
