Orthopedic Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
Department of Orthopaedic Surgery, Sint Maartenskliniek Nijmegen, Nijmegen, The Netherlands.
J Shoulder Elbow Surg. 2018 Apr;27(4):726-732. doi: 10.1016/j.jse.2017.12.013. Epub 2018 Feb 15.
Few studies have discussed the short-term results of radiocapitellar (RC) prosthetic arthroplasty (PA). In this study, we assessed the short-term to midterm functional and radiographic results of elbows after RC PA. Our secondary aim was to assess the survival of the RC PA.
We included 19 elbows in 18 patients with a mean follow-up of 35 months (range, 12-88 months). Patients were examined for instability and range of motion and were assessed using Mayo Elbow Performance Index and Oxford Elbow Score at any subsequent visits. RC PA was the primary treatment in 16 elbows, and 3 were revision radial head arthroplasty with concomitant capitellar resurfacing.
Range of motion, pain, and functional scores improved significantly from the preoperative to the final follow-up visit. Categoric grouping of the final Mayo Elbow Performance Index outcome scores showed 9 excellent, 5 good, 3 fair, 0 poor, and 2 missing data. However, stability of the elbow remained unchanged. There was no pain in 11 patients, mild pain in 5, and moderate pain in 3. Radiographic assessment showed no significant progress in ulnohumeral arthritis, although 3 elbows showed osteoarthritis progression to a higher grade. There were no major complications, including infection, revision, disassembly of the components, or conversion to total elbow arthroplasty. Survival of the RC PA was 100%.
Elbow arthritis seems to become stationary after RC PA. Symptomatic RC osteoarthritis would probably benefit from RC PA regardless of the etiology.
很少有研究讨论过放射头状突（RC）假体关节成形术（PA）的短期结果。在这项研究中，我们评估了 RC PA 后肘部的短期至中期功能和放射学结果。我们的次要目的是评估 RC PA 的存活率。
我们纳入了 18 名患者的 19 个肘部，平均随访 35 个月（范围，12-88 个月）。在随后的任何就诊时，患者均接受不稳定和活动范围的检查，并使用 Mayo 肘部功能指数和牛津肘部评分进行评估。RC PA 是 16 个肘部的主要治疗方法，3 个是 revision radial head arthroplasty 伴同时行肱骨小头表面置换术。
从术前到最终随访，活动范围、疼痛和功能评分均显著改善。最终 Mayo 肘部功能指数结果评分的分类分组显示 9 个优，5 个良，3 个可，0 个差和 2 个数据缺失。然而，肘部的稳定性保持不变。11 名患者无疼痛，5 名患者轻度疼痛，3 名患者中度疼痛。放射学评估显示，虽然 3 个肘部的关节炎进展到更高的等级，但尺肱关节炎没有明显进展。没有重大并发症，包括感染、翻修、组件拆卸或转换为全肘关节成形术。RC PA 的存活率为 100%。
RC PA 后肘部关节炎似乎趋于稳定。无论病因如何，症状性 RC 骨关节炎可能会从 RC PA 中受益。
