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Late complications with the Pritchard Mark II elbow prosthesis
F Madsen1, J O Søjbjerg, O Sneppen
1From the Shoulder and Elbow Clinic, Department of Orthopaedic Surgery, University Hospital of Århus, Århus, Denmark.
Journal of Shoulder and Elbow Surgery
|September 11, 2012
Summary
The Pritchard Mark II elbow prosthesis shows good initial pain relief and motion for rheumatoid arthritis patients. However, long-term survival rates decline significantly, with hinge disconnection being a growing concern.
Area of Science:
- Orthopedic Surgery
- Biomedical Engineering
Background:
- Rheumatoid arthritis (RA) frequently affects the elbow joint, necessitating surgical intervention.
- Elbow arthroplasty aims to restore function and alleviate pain in RA patients.
Purpose of the Study:
- To prospectively evaluate the long-term outcomes and survivorship of the Pritchard Mark II elbow prosthesis in rheumatoid arthritis patients.
Main Methods:
- Prospective follow-up of 23 consecutive RA patients with 26 Pritchard Mark II elbow prostheses.
- Kaplan-Meier survivorship analysis was employed.
- Assessment included pain relief, elbow motion, radiographic evaluation, and revision rates.
Main Results:
- At a mean follow-up of 75 months, non-revised elbows showed good to excellent pain relief and motion.
- Survivorship was 92% at 5 years but decreased to 43% at 8 years.
- Seven prostheses required revision, with hinge disconnection (4 cases) being the most frequent reason. Pin axle migration was observed in 6 unrevised prostheses.
Conclusions:
- While providing short-term benefits, the Pritchard Mark II elbow prosthesis demonstrates suboptimal long-term survivorship, particularly due to hinge failures.
- Radiographic findings like pin migration did not correlate with clinical outcomes in this cohort.
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