Article Text

AB1401 Early rehabilitation after total elbow arthroplasty improves outcome in patients with rheumatic diseases
  1. M. Votavova1,
  2. H. Jarosova1,
  3. K. Pavelka1,
  4. P. Vavrík2,
  5. S. Popelka2
  1. 1Institute of Rheumatology
  2. 2Orthopaedic clinic of second medical school Charles Univerisity, Prague, Czech Republic


Background Usual indications for elbow total joint replacement in rheumatology are rheumatoid arthritis, ankylosing spondylitis, osteoarthritis and posttraumatic arthritis. There is not much evidence of efficiency of early specialised rehabilitation on the functional outcome of patients with rheumatoid disease after this type of arthroplasty.

Objectives To evaluate the effects of surgical treatment and effect of physiotherapy in early postoperative period, on functional activity and quality of life (daily living activity).

Methods A population of 25 patients (a set of patients operated by the teams from the Orthopaedic clinic) has been monitored after total elbow replacement. We developed methodology of comprehensive rehabilitation. Patients were educated in physiotherapeutic procedures. We monitored general patient’s condition assessment using the VAS, international self-sufficiency and independence FIM test and goniometry. Physiotherapy was initiated during the pre-operation period. After operation we tested and trained routine activities of daily living, including occupation therapy. We used individual training and consulted the surgeon in all cases.

Results The rehabilitation started in the inpatient department with supervision and continued after education at home. Mean flexion of the operated joint with early physiotherapy improved by 24.2±15,2°, degrees, extension deficit improved by 11.6±7,2° in 8 weeks. Self - sufficiency results were also satisfactory (improved by 7.5 points during two weeks). Further improvement was observed after 1 year of therapy. Patients have evaluated results of operation as very good in 10/25, as good in 12/25 and 3 patients evaluated results of operation as not satisfactory.

Conclusions Early specialised physiotherapy, followed by instructed home-base exercise, improves long-term functional outcomes of after elbow joint arthroplasty in rheumatic patients.

Acknowledgements Supported by Grant MT12437-5

Disclosure of Interest None Declared

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