Department of Orthopedic Surgery, Hôpital Pierre-Paul Riquet, Toulouse, France.
Department of Orthopedic Surgery, Hôpital Pierre-Paul Riquet, Toulouse, France.
J Shoulder Elbow Surg. 2021 Sep;30(9):2105-2112. doi: 10.1016/j.jse.2021.02.009. Epub 2021 Mar 4.
Third-generation total elbow arthroplasties (TEAs) have shown better mechanical characteristics than older designs. However, these results remain purely mechanical and lack clinical evidence. The purpose of this study was to evaluate clinical and radiographic outcomes of the new-generation semiconstrained Nexel TEA performed at our center.
Between 2015 and 2017, 9 Nexel TEAs were implanted in 9 patients (mean age 61 years, range 38-71). Indication for further surgery, range of motion, mean Mayo Elbow Performance Score (MEPS), Subjective Elbow Value (SEV), radiolucency lines, outcome measures that included implant survival, complications, and revisions were assessed.
The mean follow-up was 28 months (5-46 months). Average range of motion significantly improved from pre- to postoperation, with flexion from 120° (70°-140°) to 140° (130°-155°) and supination from 60° (0°-80°) to 80° (80°). Average MEPS improved from 33 (5-45) to 85 points (30-95). During the study period, 5 elbows (56%) experienced complications and 2 (22%) underwent revision. Aseptic humeral loosening was the main indication for revision. The survivorship rate without revision was 75% at 45 months.
The short-term clinical results of the Nexel TEA are satisfactory. However, an unusually high rate of complications and revisions was observed, mainly at the humeral component. Further research with longer follow-up and more patients included are needed to validate this new prosthesis.
第三代全肘关节假体(TEA)在机械性能方面优于旧设计。然而,这些结果纯粹是机械的,缺乏临床证据。本研究的目的是评估我们中心新代半约束型 Nexel TEA 的临床和影像学结果。
2015 年至 2017 年间,9 例患者(平均年龄 61 岁,范围 38-71 岁)共植入 9 例 Nexel TEA。进一步手术的指征、活动范围、平均 Mayo 肘关节功能评分(MEPS)、主观肘关节价值(SEV)、放射透亮线、包括植入物存活率、并发症和翻修的评估结果。
平均随访时间为 28 个月(5-46 个月)。平均活动范围从术前到术后显著改善,屈曲从 120°(70°-140°)增加到 140°(130°-155°),旋前从 60°(0°-80°)增加到 80°(80°)。平均 MEPS 从 33(5-45)增加到 85 分(30-95)。在研究期间,5 例(56%)肘部出现并发症,2 例(22%)接受了翻修。无菌性肱骨干松动是翻修的主要指征。45 个月时无翻修的生存率为 75%。
Nexel TEA 的短期临床结果令人满意。然而,观察到并发症和翻修的发生率异常高,主要发生在肱骨干。需要进一步研究更长时间的随访和更多患者,以验证这种新假体。