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Published on: September 13, 2020
Long-term Outcome of Open Synovectomy with Radial Head Resection for Rheumatoid Elbow
Masanori Nakayama1, Yu Sakuma1, Hitoshi Imamura1
1* Department of Orthopedic Surgery, Institute of Rheumatology, Tokyo Women's Medical University, Tokyo, Japan.
Background:
We reviewed our surgical results of open synovectomy with radial head resection for rheumatoid elbow.
Methods:
We reviewed the 20 patients (22 elbows) underwent open synovectomy for rheumatoid elbows retrospectively. The minimum follow-up period is over 10 years, and the average was 13 years 4 months. Surgical outcomes were evaluated using the VAS pain scale, range of motion, and radiologic outcomes including Larsen's grade and carrying angle.
Results:
The mean VAS score was 39 (range, 10-90) at last follow-up. The only one patient underwent revision surgery. The mean flexion-extension range of elbow was -28°-112° and arc of motion was 82° before surgery. The mean flexion-extension range of elbow was -23°-114°, and arc of motion was 90° at last follow-up. Radiologic findings of nine elbows in 21 elbows worsened at last follow-up according to the Larsen-s grade. Carrying angle increased by mean 4.2°, and it increased by 10° or more in four elbows.
Conclusions:
Our results show that open synovectomy with radial head resection resulted in functional motion maintenance and pain control for a long time, but often resulted in an elbow valgus deformity. Our findings suggest open synovectomy can be considered as palliative treatment for painful rheumatoid elbow.
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