Abstract
Purpose
Clinical outocome of revision total elbow arthroplasty(TEA) in rheumatoid arthritis(RA) patients were evaluated.
Methods
Clinical outocome of revision TEA that underwent between 2005 and 2013 were evaluated. Causes of revision, implanted revised prosthesis, a clinical score (the Japanese Orthopaedic Association (JOA) elbow assessment score), the arc of motion and complications were investigated. Totally, 6 patients underwent revision TEA. The patients were females with a mean age of 60.4 years (range, 32 to 72).
Results
Seventy-two primary TEAs were done in corresponding period. Six out of 72 (8.3%) TEAs were revised. Causes of revision were loosening, instability (dislocation) and breakage of a component in 3, 2 and 1 cases, respectively. A mean duration from initial TEA to revision surgery was 10.3 years (range, 1 to 13). Semi-constrained arthroplasties (5 Coonrad-Morrey, 1 Discovery) were used for revision surgery.
A mean JOA elbow assessment score improved from 59 to 81 point at the time of follow up. The mean ROM, flexion was improved 125 degrees, to 131 degrees. Extension, supination and pronation was not changed.
A fracture at the time of implant withdrawal occurred as an intraoperative complication. The fractures were recovered by wiring with autologous bone graft from the ilium and a good bone union was achieved in 2 out of 3 cases. However, a re-revision surgery with plate was required in the remaining case.
Conclusions
Revision TEA provided a satisfactory functional outcome. An intraoperative fracture was a critical complication in this procedure.
