Momtaz David, Ahmad Farhan, Cushing Tucker, Gonuguntla Rishi, Ghali Abdullah, Jabin Mohamad, Miggins John, Khalafallah Youssef, Mitchell Scott
Long School of Medicine, UT Health Science Center at San Antonio, San Antonio, TX, USA.
Department of Orthopedics, Rush University Medical Center, Chicago, IL, USA.
J Shoulder Elb Arthroplast. 2023 Jan 26;7:24715492231152735. doi: 10.1177/24715492231152735. eCollection 2023.
Primary elbow osteoarthritis affects approximately 2% of the population, and has been treated with arthroplasty. However, total elbow arthroplasty (TEA) implants currently have severe weight limitations and issues with longevity. In patients with unicompartmental arthritis, unicompartmental arthroplasty may be used instead of TEA. We describe the use of Uni-Elbow Radio-Capitellum and Lateral Resurfacing Elbow for radiocapitellar arthroplasty (RCA) in this article.
Reviewers independently searched databases for keywords, such as radiocapitellar arthroplasty, RCA, uni-elbow radiocapitellum, UNI-E, and lateral resurfacing elbow, LRE. The measured outcomes of interest were the change in motion arc and patient-reported outcome scores. Studies that were not of appropriate quality determined by the Cochrane risk of bias summary tool and review studies were excluded.
RCA resulted in a postoperative 38.3° ± 28.5° increase in elbow flexion-extension (< .001), and 35.2° ± 28.6° increase in elbow pronation-supination (< .001). Mayo Elbow Performance Score was significantly increased by 44.8 ± 12.6. DASH Score saw a significant reduction by 45.0 ± 14.6 points ( < .001), while the American Shoulder and Elbow Surgeons Score increased by 47.0 ± 10.6 points (< .001). Of the 105 adult patients 16.2% experienced complications such as minor stiffness, ulnar neuropathy, component loosening, or radial head UNI-E stem failure. Reported complications were higher in the UNI-E group than in the LRE group.
RCA has shown promise as an option to treat radiocapitellar arthritis, particularly when excising the radial head causes lateral column instability.
原发性肘关节骨关节炎影响约2%的人群，一直采用关节成形术进行治疗。然而，目前的全肘关节置换术（TEA）植入物存在严重的重量限制和使用寿命问题。在单髁关节炎患者中，可使用单髁关节成形术代替TEA。在本文中，我们描述了使用单髁肘关节桡骨头和外侧表面置换肘关节进行桡骨头关节成形术（RCA）的情况。
reviewers独立在数据库中搜索关键词，如桡骨头关节成形术、RCA、单髁肘关节桡骨头、UNI-E和外侧表面置换肘关节、LRE。感兴趣的测量结果是活动弧的变化和患者报告的结果评分。由Cochrane偏倚风险总结工具确定质量不合适的研究和综述研究被排除。
RCA术后肘关节屈伸增加38.3°±28.5°（<0.001），肘关节旋前旋后增加35.2°±28.6°（<0.001）。Mayo肘关节功能评分显著提高44.8±12.6。DASH评分显著降低45.0±14.6分（<0.001），而美国肩肘外科医生评分提高47.0±10.6分（<0.001）。在105例成年患者中，16.2%出现了轻微僵硬、尺神经病变、假体松动或桡骨头UNI-E柄失败等并发症。报告的并发症在UNI-E组高于LRE组。
RCA已显示出作为治疗桡骨头关节炎的一种选择的前景，特别是在切除桡骨头导致外侧柱不稳定时。
