Abstract:Objective To analyze the clinical efficacy of total elbow arthroplasty in the treatment of advanced elbow joint rheumatoid arthritis.Methods Eleven patients with elbow joint rheumatoid arthritis treated in the Department of Orthopedics in Jiangsu Provincial Hospital of TCM from January 2012 to June 2018 were selected.All 11 patients were unilateral and all patients underwent total elbow arthroplasty.There were 3 males and 8 females;the age ranged from 46 to 91 years,with an average age of (59.55±12.28) years.The Mayo score,C-reactive protein,rheumatoid factor,erythrocyte sedimentation rate and complications of the elbow joint were compared before surgery,10 days after surgery,3 months after surgery and last follow-up.Results All patients were followed up for 12~66 months with an average of (26.6±15.1) months.The Mayo scores of patients before surgery,10 days after surgery,3 months after surgery and last follow-up were (30.91±9.86),(62.00±5.22),(85.55±6.93),and (91.93±4.01),respectively.The pain scores were (16.00±7.68),(25.27±3.29),(38.18±4.05),and (41.83±2.31),respectively.The motor function scores were (3.27±1.85),(14.00±2.14),(17.54±2.16),and (18.11±1.61),respectively,the postoperative period was significantly improved compared with preoperative and preoperative.The postoperative rheumatoid factor and erythrocyte sedimentation rate showed a downward trend,and C-reactive protein increased slightly on the 10th postoperative day.The postoperative 3 months after surgery and last follow-up decreased compared with the preoperative period.X-ray films showed no prosthesis wear,loosening and rupture during the follow-up period,abnormal position of the prosthesis,periprosthetic fracture,heterotopic ossification,etc.Survival rate was 100%.There was no infection after operation,no nerve injury,and the incision was difficult to heal in 1 case (9.11%).The incision healed after dressing for 3 weeks.Pain around the elbow occurred during follow-up was found in 1 case (9.11%) and relieved by administration of analgesic drugs and functional training.All patients were discharged from hospital,and no other complications occurred at the last follow-up.Conclusion Artificial total elbow arthroplasty is effective in the treatment of advanced elbow joint rheumatoid arthritis,which is beneficial to improve the elbow joint function and reduce inflammation in patients,and it is safe and worth promotion.
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