Complications and Revision Rate as the Type of Prosthesis of Total Elbow Replacement: Long-term Follow-up in Korea / 대한정형외과학회잡지

PURPOSE: Few studies have compared the outcomes, complications and revision rate of a total elbow replacement (TER) prosthetic design. This study examined a series of patients with semiconstrained and unconstrained total elbow replacements (TER) and evaluated them for any functional differences, complications and revision rates that might be attributable to the prosthetic design. MATERIALS AND METHODS: A total 78 cases of primary TER was performed in 71 patients. Their mean age at TER was 54 years. The causes of TER were rheumatoid arthritis in 42, post-traumatic arthritis and osteoarthritis 24 and 5 patients, respectively. Unconstrained and semiconstrained TER was employed in 35 and 43 cases, respectively. The end results of TER by the Mayo elbow performance score (MEPS), their elbow range of motion before and after surgery, their complications and revision rates after an average 13 year follow-up were evaluated. RESULTS: The MEPS was improved from 33 points pre-operatively to 87 points post-operatively (p<0.001). Active flexion-extension elbow motions were also improved markedly from 27degrees-86degrees pre-operatively to 16degrees-128degrees postoperatively (p<0.001). There was no significant difference between the semiconstrained and unconstrained TER in the post-operative MEPS (p=0.764) and range of motion (p=0.728). The complication rate was much higher in the unconstrained groups than in the semiconstrained group (p=0.014). The mean total revision rate was 29.5%. There was no significant difference in revision rate between the unconstrained and semiconstrained groups (p=0.402). Loosening was found in a total of 12 cases (15.4%). There was also no significant difference in loosening between the semiconstrained and unconstrained groups (p=0.382). CONCLUSION: Favorable results of MEPS and elbow motion were obtained in both the unconstrained and semiconstrained types after an average 13 year follow up after TER. However, the semiconstrained type of TER showed a lower complication rate than the unconstrained type of TER.

Total Ankle Arthroplasty : Short Term follow up Results of Semiconstrained Type and Unconstrained Type / 대한족부족관절학회지

PURPOSE: The purpose of this study is to compare the two prosthesis that used for total ankle arthroplasty. MATERIALS AND METHODS: From Sept. 2003 to Jun 2006, 13 patients and 14 ankles that could be follow up more than 1 months. Semiconstrained type (Group I, 7 cases) and Unconstrained type (Group II, 7 cases) were used for total ankle arthroplasty. Mean age was 63.2 year-old, 12 ankles are men and 2 ankles were women. Mean follow up periods were 29 months. The criteria to compare the clinical result were postoperative range of motion, AOFAS score and residual bone stock of medial malleolus. RESULTS: Postoperative range of motion of group I was 43.6+/-9.4 degrees and of group II was 50.7+/-7.3 degrees (p=0.115). Postoperative AOFAS score of group I was 77.1+/-13.0 points and of group II was 86.0+/-5.7 points (p=0.094). Resected bone stock in medial malleolus of group I was 10.7+/-2.5 mm and of group II was 5.1+/-1.2 mm (p=0.003). Total number of complication in our study was 9 cases. 3 cases were a malleolar fracture, two occurred at intra-operation, the other at follow-up period. Re-operation was done in 6 cases, 3 cases were calcaneal corrective osteotomy, 2 cases were resection of a heterotopic bone and one case was pedicular flap operation for skin problem. CONCLUSION: In our hospital, mobile bearing type prosthesis shows good result than a semiconstrained type in respect of residual bone stock in medial malleolus. Postoperative range of motion and AOFAS score between two groups shows no significant difference. But small number of patients and short term follow up period is a defect in our study, afterward more population and long term follow up period are needed.