Original articleThe Kudo total elbow arthroplasty in patients with rheumatoid arthritis
Section snippets
Materials and methods
Between 1991 and 2002, 36 elbows (22 right and 14 left) were replaced with a Kudo prosthesis (Biomet Ltd, South Glamorgan, United Kingdom) (type 4 and 5) in 35 patients with RA. All elbows were in Larsen stages 4 and 5.15 There were 12 men and 23 women with a mean age of 57.5 years (range, 36-74 years). The mean duration between the onset of rheumatoid disease and the prosthetic implantation was 17 years (range, 3-38 years). An open synovectomy and radial head excision had been performed
Clinical results
The results are summarized in Table I. Twenty-four elbows were followed for a mean of 58 months (range, 8-114 months) postoperatively; 4 patients died, 6 were excluded because of revision, and 2 were lost during follow-up. Postoperatively, 14 patients were pain-free, 7 had mild pain, and 3 had moderate pain. Sixteen patients had excellent or good results by use of the Hospital for Special Surgery 2 score, and fifteen had excellent or good results by use of the Mayo score.
There was improvement
Discussion
The number of elbow arthroplasties performed for the 9-year period in this study is probably typical for most surgeons performing elbow arthroplasty for RA. A preliminary report was published from the same department in 1998, with mainly excellent and good results.11 Resurfacing prostheses have the advantage of minimal bone resection and minimal stresses at the interfaces. Patients with RA affecting multiple joints have lower functional demands than those with other diagnoses. Although our
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