Department of Orthopaedics and Traumatology, Kantonsspital St. Gallen, St. Gallen, Switzerland; Faculty of Medicine, University of Zürich, Zürich, Switzerland.
AZ Monica Hospital, Orthopaedic Centre Antwerp and Monica Orthopaedic Research (MoRe) Foundation, Antwerp, Belgium.
J Shoulder Elbow Surg. 2019 Jan;28(1):131-136. doi: 10.1016/j.jse.2018.08.009. Epub 2018 Oct 19.
The aim of this study was to analyze indications, outcomes, and complications in patients treated with radiocapitellar arthroplasty.
This prospective analysis of clinical and radiographic results included 16 elbows in 15 patients.
This study included 4 men and 11 women (mean age, 51.9 years; age range, 32-65 years). The mean follow-up period was 3.4 years (range, 2-6 years). The indications were post-traumatic (n = 10) and primary radiohumeral osteoarthritis (n = 6). A mean of 2 surgical procedures (range, 0-4) had been performed before radiocapitellar arthroplasty. The mean Mayo Elbow Performance Score significantly improved from 46 points to 85 points (P < .01). The arc of motion improved from 106° to 117° (P = .27). Radiographic ulnohumeral degeneration progressed in 40% of cases but was not symptomatic in any. Subsequent surgery was required in 5 elbows (31%). Revision of the radial head component was necessary in 4 patients (25%). In 3 patients this was a result of loosening of the stem. The radial component was subsequently removed because of persistent pain in 1. Radiographic loosening not requiring revision was found in 2 patients.
The overall Mayo Elbow Performance Score was good to excellent after radiocapitellar arthroplasty. Both the revision and reoperation rates were high, and one should consider this before performing this procedure. Loosening of the radial head component was a problem. An improved fixation technique or an adaptation of the design is needed before this type of surgery can be recommended as a standard procedure.
本研究旨在分析接受放射状髁突关节成形术治疗的患者的适应证、结果和并发症。
这是一项对临床和影像学结果的前瞻性分析，共纳入 15 例患者的 16 个肘部。
本研究包括 4 名男性和 11 名女性（平均年龄 51.9 岁；年龄范围 32-65 岁）。平均随访时间为 3.4 年（范围 2-6 年）。适应证为创伤后（n=10）和原发性桡肱关节炎（n=6）。放射状髁突成形术之前平均进行了 2 次手术（范围 0-4 次）。 Mayo 肘功能评分从 46 分显著提高至 85 分（P<0.01）。活动度从 106°改善至 117°（P=0.27）。40%的病例出现尺肱关节退行性变，但无任何症状。5 个肘部（31%）需要再次手术。4 例（25%）需要修改头状突组件。其中 3 例是由于柄部松动。1 例因持续疼痛而随后取出了桡骨组件。在 2 例患者中发现了不需要修改的放射性松动。
放射状髁突成形术后，总体 Mayo 肘功能评分良好至优秀。翻修和再次手术的发生率都很高，在进行该手术之前应考虑这一点。头状突组件的松动是一个问题。在推荐这种手术作为标准手术之前，需要改进固定技术或设计。
