Heifner John J, Falgiano Peter A, Yergler Thomas O, Davis Ty A, Hoekzema Nathan A, Orbay Jorge L
Miami Orthopaedic Research Foundation, Coral Gables, FL, USA.
Larkin Hospital Department of Orthopaedic Surgery, Coral Gables, FL, USA.
Shoulder Elbow. 2025 Jul;17(3):332-340. doi: 10.1177/17585732241246756. Epub 2024 Apr 16.
Compared to total elbow arthroplasty, elbow hemiarthroplasty (EHA) does not have an ulnar component or a hinge/link which eliminates complication risk due to polyethylene wear and ulnar loosening. There are notable gaps in the existing EHA literature. Patient age is often identified as an important determinant when deciding to treat with EHA; however, there is limited age-based evidence. Our systematic review objectives were (a) to compare EHA outcomes between younger and older adults, and (b) to stratify outcomes for EHA by prosthesis.
In compliance with PRISMA guidelines, databases were searched for EHA studies and 65 years was used to delineate younger and older adults.
Older adults (N = 159) had a significantly higher elbow arc of motion compared to younger adults (N = 121) at a mean follow-up of 51 months. There was a significantly increased risk for a MEPS below 75 in younger compared to older adults. Mean Disabilities of the Arm, Shoulder, and Hand scores and rates of revision/removal were comparable between age groups.
The current findings suggest that although elbow range of motion may be limited in younger adults following EHA, function is satisfactory and comparable to the function in older adults. Additionally, the risk of revision/removal surgery is similar between younger and older adults across short to mid-terms of follow-up.
与全肘关节置换术相比,肘关节半关节成形术(EHA)没有尺骨部件或铰链/连杆,从而消除了因聚乙烯磨损和尺骨松动导致的并发症风险。现有的EHA文献存在显著空白。在决定采用EHA治疗时,患者年龄常被视为一个重要的决定因素;然而,基于年龄的证据有限。我们的系统评价目标是:(a)比较年轻人和老年人EHA的疗效;(b)按假体对EHA的疗效进行分层。
按照PRISMA指南,检索数据库中的EHA研究,并以65岁为界划分年轻人和老年人。
在平均51个月的随访中,老年人(N = 159)的肘关节活动弧度明显高于年轻人(N = 121)。与老年人相比,年轻人MEPS低于75的风险显著增加。年龄组之间的平均上肢、肩部和手部残疾评分以及翻修/取出率相当。
目前的研究结果表明,尽管EHA术后年轻人的肘关节活动范围可能有限,但功能令人满意,与老年人的功能相当。此外,在短期至中期随访中,年轻人和老年人进行翻修/取出手术的风险相似。