In:
The Journal of Bone and Joint Surgery. British volume, British Editorial Society of Bone & Joint Surgery, Vol. 79-B, No. 6 ( 1997-11), p. 918-923
Abstract:
We carried out a survival analysis of elbow synovectomy (ES) and excision of the radial head (RHE) performed on 171 rheumatoid elbows. The failure criteria were revision surgery (performed or desired) and/or the presence of significant or severe pain. The cumulative survival was 81% at one year which thereafter decreased by an average of 2.6% per year. The strongest predictor for success was a low preoperative range of supination-pronation when corresponding survival curves were compared. A low range of flexion-extension also predicted failure. Combining both factors gave better prediction (failure: 6.3% v 67%), but a long duration of elbow symptoms before surgery predicted failure (72%, p = 0.04). At review, there was a mean gain of 50° in supination-pronation and 11° in flexion-extension; both correlated with success. Failure correlated with recurrence of synovitis, elbow instability, ulnar neuropathy, poor general mobility and poor upper-limb function. The last was independently affected by the severity of RA in the ipsilateral shoulder. Our findings show that although the short-term result of ES and RHE in rheumatoid arthritis is good, the long-term outcome is poor except in a subgroup with more than 50% limitation of forearm rotation.
Type of Medium:
Online Resource
ISSN:
0301-620X
,
2044-5377
DOI:
10.1302/0301-620X.79B6.0790918
Language:
English
Publisher:
British Editorial Society of Bone & Joint Surgery
Publication Date:
1997
detail.hit.zdb_id:
2697480-0
detail.hit.zdb_id:
2039886-4
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