Feldman Joshua William, Boekel Pamela, Watts Adam Charles
Department of Orthopaedic Surgery, Wrightington Hospital, Wigan, Lancashire, UK.
Department of Orthopaedic Surgery, The Northern Hospital, Epping, Victoria, Australia.
Shoulder Elbow. 2025 Aug 7:17585732251365579. doi: 10.1177/17585732251365579.
Proximal radio-ulnar stump impingement (PRUSI) describes a painful condition occurring following radial head loss. Pain occurs due to the proximal radial stump impinging against the ulna. This study aimed to evaluate the safety of a novel interposition arthroplasty method.
A retrospective observational consecutive case series study was undertaken from case note review of patients with PRUSI, treated by Achilles allograft interposition arthroplasty. The technique utilised donor Achilles tendons to cushion the proximal radio-ulnar stump articulation. The primary outcome was a change in pain levels. Secondary outcomes included changes in: elbow and forearm range of movement, Mayo Elbow Performance Score (MEPS), patient satisfaction on an 11-point numerical rating scale (NRS) and adverse events.
From baseline to six months post intervention, the mean NRS pain score was reduced from 9/10 to 2/10 with a mean difference in NRS pain scores of -7 (95% CI -4, -10; p = 0.004). Mean MEPS increased from 56/100 (s.d. 8) to 91 (s.d. 8), with a mean difference of 35/100 (95% CI 18, 52; p = 0.005).
Achilles tendon allograft arthroplasty represents a safe procedure for treating PRUSI. This IDEAL phase 1 study shows promising results, indicating the need for further trials.
近端桡尺骨残端撞击（PRUSI）描述了桡骨头缺失后出现的一种疼痛状况。疼痛是由于近端桡骨残端撞击尺骨所致。本研究旨在评估一种新型间置关节成形术方法的安全性。
通过对接受跟腱同种异体间置关节成形术治疗的PRUSI患者的病历回顾，进行了一项回顾性观察性连续病例系列研究。该技术利用供体跟腱来缓冲近端桡尺骨残端关节。主要结局是疼痛水平的变化。次要结局包括：肘部和前臂活动范围、梅奥肘关节功能评分（MEPS）、患者在11分数字评分量表（NRS）上的满意度以及不良事件。
从基线到干预后6个月，平均NRS疼痛评分从9/10降至2/10，NRS疼痛评分的平均差异为-7（95%CI -4，-10；p = 0.004）。平均MEPS从56/100（标准差8）增至91（标准差8），平均差异为35/100（95%CI 18，52；p = 0.005）。
跟腱同种异体关节成形术是治疗PRUSI的一种安全手术。这项IDEAL 1期研究显示了有前景的结果，表明需要进一步试验。
