Beckenbaugh R D
J Am Geriatr Soc. 1977 Feb;25(2):68-75. doi: 10.1111/j.1532-5415.1977.tb00233.x.
The principles ot total joint arthroplasty recently have been expanded to the upper extremity, following the dramatic success with total hip and total knee replacement procedures. New problems have been encountered with the rebalancing of the soft tissues and the technical nature of joint mechanics in the upper extremities. Work on shoulder joint replacement is in the very early stages and of unknown success. Several prostheses are being used and tested. For elbow and wrist replacement, early and predictable success has been accomplished, enabling relief of pain and satisfactory motion. Total joint replacement in the fingers and thumb has provided excellent relief of pain but has been hindered by difficulties in rebalancing the soft tissues in patients with rheumatoid arthritis. It appears that total reconstruction of arthritic upper-extremity joints will be commonplace in the not-too-distant future. Clinical trials are being expanded, with increasing success.
随着全髋关节和全膝关节置换手术取得巨大成功，全关节置换术的原则最近已扩展到上肢。在上肢软组织重新平衡和关节力学技术性质方面出现了新问题。肩关节置换工作尚处于非常早期阶段，成功率未知。几种假体正在使用和测试中。对于肘关节和腕关节置换，已取得早期且可预测的成功，能够缓解疼痛并实现令人满意的活动。手指和拇指的全关节置换已极大地缓解了疼痛，但类风湿性关节炎患者软组织重新平衡的困难阻碍了其发展。看来，在不太遥远的将来，关节炎上肢关节的全重建将变得普遍。临床试验正在扩大，且越来越成功。
