Rozing P M
Academisch Ziekenhuis, afd. Orthopedic, Leiden.
Ned Tijdschr Geneeskd. 1998 May 30;142(22):1256-61.
In functional impairment of a joint due to pain and (or) limited mobility in which conservative measures are inadequate, an operation may be considered. The principal possibilities are arthrodesis and implantation of an artificial joint. Reasons to opt for a prosthesis are involvement of adjacent articulations (in rheumatoid arthritis) and preservation of mobility which, together with stability, is necessary for good articular function. The principal indications for implantation of an artificial joint in the upper extremity are rheumatoid arthritis and (to a lesser degree) osteoarthritis and posttraumatic impairments. The functional results of prostheses in the shoulder, elbow and wrist are good, but the proportion of complications is relatively large (compared with that in hip and knee prostheses) and follow-up so far has only been short.
对于因疼痛和（或）活动受限导致关节功能障碍且保守治疗措施不足的情况，可考虑进行手术。主要的手术方式有关节融合术和人工关节植入术。选择假体的原因包括相邻关节受累（类风湿关节炎）以及保留活动度，而活动度与稳定性对于良好的关节功能都是必要的。上肢人工关节植入的主要适应证是类风湿关节炎以及（程度较轻的）骨关节炎和创伤后功能障碍。肩部、肘部和腕部假体的功能效果良好，但并发症比例相对较大（与髋部和膝部假体相比），且目前随访时间较短。
