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Capitellocondylar total elbow arthroplasty

F C Ewald, R D Scheinberg, R Poss

    The Journal of Bone and Joint Surgery. American Volume
    |December 1, 1980
    PubMed
    Summary
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    Total elbow replacement using capitellocondylar prostheses improved flexion and pronation in rheumatoid arthritis patients. While 87% had good outcomes, a 39% complication rate, including revisions, was observed.

    Area of Science:

    • Orthopedic Surgery
    • Rheumatology
    • Biomedical Engineering

    Background:

    • Rheumatoid arthritis frequently affects the elbow joint, causing pain and functional limitation.
    • Total elbow arthroplasty is a surgical option for end-stage rheumatoid arthritis of the elbow.

    Purpose of the Study:

    • To evaluate the clinical outcomes and complication rates of non-constrained capitellocondylar total elbow replacement in rheumatoid arthritis patients.
    • To assess the impact of this prosthesis on range of motion, pain, and function.

    Main Methods:

    • A retrospective study of 69 total elbow replacements in 64 rheumatoid arthritis patients.
    • Follow-up averaged 3.5 years, assessing postoperative range of motion, pain, and function using a standardized rating system.
    • Radiographic evaluation for radiolucent lines and complications was performed.

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    Main Results:

    • Significant improvements in postoperative flexion and pronation were observed.
    • No significant increase in extension or supination was demonstrated.
    • 87% of patients achieved good or excellent results based on pain and function.
    • The overall complication rate was 39%, with 8 revisions required for dislocation, sepsis, loosening, and fracture.
    • Asymptomatic radiolucent lines were noted adjacent to the ulnar component in 8 patients.

    Conclusions:

    • Capitellocondylar total elbow arthroplasty can effectively improve flexion and pronation in rheumatoid arthritis patients.
    • While functional outcomes are often favorable, a notable complication rate necessitates careful patient selection and monitoring.
    • Radiographic signs of loosening may occur, particularly around the ulnar component.