ID | 65732 |
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Nishida, Keiichiro
Department of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
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Nasu, Yoshihisa
Department of Orthopaedic Surgery, Okayama University Hospital
Hashizume, Kenzo
Department of Orthopaedic Surgery, Chugoku Central Hospital
Okita, Shunji
Department of Orthopaedic Surgery, Okayama Saiseikai General Hospital
Nakahara, Ryuichi
Department of Orthopaedic Surgery, Okayama University Hospital
Saito, Taichi
Department of Intelligent Orthopaedic System, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
Ozaki, Toshifumi
Department of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
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Inoue, Hajime
Department of Orthopaedic Surgery, Science of Functional Recovery and Reconstruction, Faculty of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
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Abstract | Aims
There are concerns regarding complications and longevity of total elbow arthroplasty (TEA) in young patients, and the few previous publications are mainly limited to reports on linked elbow devices. We investigated the clinical outcome of unlinked TEA for patients aged less than 50 years with rheumatoid arthritis (RA). Methods We retrospectively reviewed the records of 26 elbows of 21 patients with RA who were aged less than 50 years who underwent primary TEA with an unlinked elbow prosthesis. The mean patient age was 46 years (35 to 49), and the mean follow-up period was 13.6 years (6 to 27). Outcome measures included pain, range of motion, Mayo Elbow Performance Score (MEPS), radiological evaluation for radiolucent line and loosening, complications, and revision surgery with or without implant removal. Results The mean MEPS significantly improved from 47 (15 to 70) points preoperatively to 95 (70 to 100) points at final follow-up (p < 0.001). Complications were noted in six elbows (23%) in six patients, and of these, four with an ulnar neuropathy and one elbow with postoperative traumatic fracture required additional surgeries. There was no revision with implant removal, and there was no radiological evidence of loosening around the components. With any revision surgery as the endpoint, the survival rates up to 25 years were 78.1% (95% confidence interval 52.8 to 90.6) as determined by Kaplan-Meier analysis. Conclusion The clinical outcome of primary unlinked TEA for young patients with RA was satisfactory and comparable with that for elderly patients. A favourable survival rate without implant removal might support the use of unlinked devices for young patients with this disease entity, with a caution of a relatively high complication rate regarding ulnar neuropathy. |
Keywords | Total elbow arthroplasty
Rheumatoid arthritis
Unlinked elbow
Less than fifty years old
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Published Date | 2023-01-13
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Publication Title |
Bone & Joint Open
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Volume | volume4
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Issue | issue1
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Publisher | British Editorial Society of Bone & Joint Surgery
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Start Page | 19
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End Page | 26
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ISSN | 2633-1462
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Content Type |
Journal Article
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language |
English
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OAI-PMH Set |
岡山大学
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Copyright Holders | © 2023 Author(s) et al.
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File Version | publisher
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Related Url | isVersionOf https://doi.org/10.1302/2633-1462.41.BJO-2022-0151.R1
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License | https://creativecommons.org/licenses/by-nc-nd/4.0/
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Citation | Nishida K, Nasu Y, Hashizume K, et al. Outcome of unlinked total elbow arthroplasty for rheumatoid arthritis in patients younger than 50 years old. Bone Jt Open. 2023;4(1):19-26. doi:10.1302/2633-1462.41.BJO-2022-0151.R1
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