Watkins C E L, Elson D W, Harrison J W K, Pooley J
Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK.
Queen Elizabeth Hospital, Gateshead Health NHS Foundation Trust, Sheriff Hill, Gateshead, Tyne and Wear NE9 6SX, UK.
Bone Joint J. 2018 Mar 1;100-B(3):338-345. doi: 10.1302/0301-620X.100B3.BJJ-2017-0865.R1.
The aim of this study was to report the long-term outcome and implant survival of the lateral resurfacing elbow (LRE) arthroplasty in the treatment of elbow arthritis.
We reviewed a consecutive series of 27 patients (30 elbows) who underwent LRE arthroplasty between December 2005 and January 2008. There were 15 women and 12 men, with a mean age of 61 years (25 to 82). The diagnosis was primary hypotrophic osteoarthritis (OA) in 12 patients (14 elbows), post-traumatic osteoarthritis (PTOA) in five (five elbows) and rheumatoid arthritis (RA) in ten patients (11 elbows). The mean clinical outcome scores including the Mayo Elbow Performance Score (MEPS), the American Shoulder and Elbow Surgeons elbow score (ASES-e), the mean range of movement and the radiological outcome were recorded at three, six and 12 months and at a mean final follow-up of 8.3 years (7.3 to 9.4). A one sample t-test comparing pre and postoperative values, and survival analysis using the Kaplan-Meier method were undertaken.
A statistically significantly increased outcome score was noted for the whole group at each time interval. This was also significantly increased at each time in each of the subgroups (OA, RA, and PTOA). Implant survivorship was 100%.
We found that the LRE arthroplasty, which was initially developed for younger patients with osteoarthritis, is an effective form of surgical treatment for a wider range of patients with more severe degenerative changes, irrespective of their cause. It is therefore a satisfactory alternative to total elbow arthroplasty (TEA) and has lower rates of complications in the subgroups of patients we have studied. It does not require activities to be restricted to the same extent as following TEA. Based on this experience, we now recommend LRE arthroplasty rather than TEA as the primary form of implant for the treatment of patients with OA of the elbow. Cite this article: Bone Joint J 2018;100-B:338-45.
本研究旨在报告外侧表面置换型肘关节（LRE）置换术治疗肘关节关节炎的长期疗效及植入物存活率。
我们回顾了2005年12月至2008年1月期间连续接受LRE置换术的27例患者（30个肘关节）。其中女性15例，男性12例，平均年龄61岁（25至82岁）。诊断为原发性萎缩性骨关节炎（OA）12例（14个肘关节），创伤后骨关节炎（PTOA）5例（5个肘关节），类风湿关节炎（RA）10例（11个肘关节）。记录了患者在3个月、6个月和12个月时以及平均最终随访8.3年（7.3至9.4年）时的平均临床疗效评分，包括梅奥肘关节功能评分（MEPS）、美国肩肘外科医师协会肘关节评分（ASES - e）、平均活动范围以及影像学结果。采用单样本t检验比较术前和术后值，并使用Kaplan - Meier方法进行生存分析。
在每个时间间隔，整个组的疗效评分均有统计学意义的显著提高。在每个亚组（OA、RA和PTOA）的每次随访中，评分也均有显著提高。植入物存活率为100%。
我们发现，最初为患有骨关节炎的年轻患者开发的LRE置换术，对于更广泛的、具有更严重退行性改变的患者，无论其病因如何，都是一种有效的手术治疗方式。因此，它是全肘关节置换术（TEA）的一种令人满意的替代方法，并且在我们研究的患者亚组中并发症发生率较低。与TEA术后相比，它对活动的限制程度较低。基于此经验，我们现在推荐LRE置换术而非TEA作为治疗肘关节OA患者的主要植入方式。引用本文：《骨与关节杂志》2018年；100 - B：338 - 45。
