Objectives to evaluate effectiveness, the clinical outcomes and quality of life before and after total elbow arthroplasty using semiconstrained prostheses Coonrad-Morrey in patients with rheumatoid elbow.
Methods Total elbow arthroplasty of 19 elbow was performed on in 18 patients with RA with radiographic changes of Larsen grade 5 or 6 (osteolytic destruction or ankylosis elbow). Patients had severe pain and instability, or absense of moution. We evaluated range of motion and pain. The Mayo Elbow Performance Score and Oxford Elbow Score was used to assess total elbow function; EQ-5D, HAQ – for evaluation quality of life.
Results The average age of patients was 44,4±14,61 years (20 to 72 years) and there was a 16 female and 2 male (8:1). There were 66,7% seropositive patients. The mean of follow up was 18.5±5,2 months (ranging from 6 months to 3 years). The average duration of RA was 15,0±6,06 years. The average duration elbow complains 8?88±5,23 years. There were pain in 100% patients, synovitis and contrarture of elbow joint.
The average increase in flexion was from 102,77±19,75° preoperatively to 116,67°±9,62° and extension was from 51,66±37,04° preoperatively to 24,33°±12,81° at short term follow up (p< 0.05). The average increase in Mayo Elbow Score 37,77/82,2 and Oxford Elbow Score 20,44/39,3 on long term follow up (p < 0.05). The mean EQ-5D (index) score improved from 0,36 to 0,72, HAQ from 1,67 to 1,22; VAS from 48 to 22. There was no neurovascular complication and infection, but in 6 cases (28,57%) were recurrent synovitis. Complications included 2 cases loosening of ulnar component, two cases of ulnar nerve palsy/neurapraxia and 2 cases elbow stiffnes.
Conclusions Good function can be achieved in the short term with the Coonrad-Morrey-semiconstrained total elbow replacement prosthesis in patients with RA with severe elbow destruction
References rheumatoid arthritis, elbow arthroplasty
Disclosure of Interest None Declared