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Journal of the Korean Society for Surgery of the Hand 2004;9(3):123-130.
Published online September 1, 2004.
Semi-constrained Total Elbow Arthroplasty in Rheumatoid Arthritis
Yoo-Joon Suh, Seok-Whan Song, Seung-Koo Rhee, Dong-Sun Im
류마토이드 관절염 환자에서 시행한 반구속형 주관절 전치환술
서유준, 송석환, 이승구, 임동선
Abstract
Objective: To analyze the clinical results of the semiconstrained total elbow arthroplasty in rheumatoid arthritis. Methods: The clinical results of twelve elbows of 11 patients, who underwent semi-constrained total elbow arthroplasty for the treatment of rheumatoid arthritis during the period of November 1997 and March 2003, were analyzed. The average follow-up period was 26.9 months (average, 12~84 months). The patients were evaluated with the Mayo elbow performance score. Results: The preoperative active range of motion was flexion contracture 25.8¡Æ(range, 10¡Æ~ 50¡Æ) and further flexion 96.3¡Æ(range, 15¡Æ~ 135¡Æ). The postoperative active range of motion increased to flexion contracture 16.3¡Æ(range, 0¡Æ~ 3 0¡Æ) and further flexion 125.8¡Æ(range , 95¡Æ~ 140¡Æ). The mean Mayo elbow performance score improved from 37.9 points (range, 15~85 points) to 84.2 points (range, 65~100 points). The overall results were excellent in five cases, good in four cases, and fair in three cases. Complications occurred in 6 cases (50%), including 1 case of ulnar nerve dysfunction, 3 cases of intraoperative fracture, 3 cases of postoperative periprosthetic fracture, 1 case of implant loosening, and 1 case of polyethylene wear. Conclusions: Although the total elbow arthroplasty is a technically demanding procedure and the complication rate is high, the semi-constrained total elbow arthroplasty is a preferable option with a satisfactory functional result for the treatment of advanced rheumatoid arthritis.
 


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