BACKGROUND: Both components of the Kudo type 5 elbow prosthesis can be inserted with or without the use of cement. There have been no reports on the use of this prosthesis with all components uncemented in patients with rheumatoid arthritis. PATIENTS AND METHODS: We reviewed 49 primary uncemented Kudo type 5 elbow prostheses, inserted in 36 patients with rheumatoid arthritis, after mean 6 (2-10) years. Patients were assessed clinically both pre- and postoperatively (pain, instability, motion, ulnar neuropathy) and radiographically. Furthermore, at the time of follow-up clinical outcome was assessed using the Elbow Function Assessment Scale. RESULTS: At review, 7 of 49 elbows had undergone revision because of symptomatic loosening of the ulnar component. In 42 unrevised elbows, clinical outcome was excellent in 29, good in 7, fair in 5, and poor in one. 31 of 42 elbows had no pain; 11 were painful at rest (VAS 1-2) and/or as a result of activity (VAS 1-8). With revision as endpoint, survival was 86% at 6 years. Intraoperative malpositioning of the ulnar component with a valgus or varus alignment of < 5 degrees was associated with worse survival. INTERPRETATION: We found an unexpectedly high rate of loosening of the ulnar component, which was associated with intraoperative malpositioning of the prosthesis. The ulnar component of this prosthesis should not be inserted without cement in patients with rheumatoid arthritis.
BACKGROUND: Both components of the Kudo type 5 elbow prosthesis can be inserted with or without the use of cement. There have been no reports on the use of this prosthesis with all components uncemented in patients with rheumatoid arthritis. PATIENTS AND METHODS: We reviewed 49 primary uncemented Kudo type 5 elbow prostheses, inserted in 36 patients with rheumatoid arthritis, after mean 6 (2-10) years. Patients were assessed clinically both pre- and postoperatively (pain, instability, motion, ulnar neuropathy) and radiographically. Furthermore, at the time of follow-up clinical outcome was assessed using the Elbow Function Assessment Scale. RESULTS: At review, 7 of 49 elbows had undergone revision because of symptomatic loosening of the ulnar component. In 42 unrevised elbows, clinical outcome was excellent in 29, good in 7, fair in 5, and poor in one. 31 of 42 elbows had no pain; 11 were painful at rest (VAS 1-2) and/or as a result of activity (VAS 1-8). With revision as endpoint, survival was 86% at 6 years. Intraoperative malpositioning of the ulnar component with a valgus or varus alignment of < 5 degrees was associated with worse survival. INTERPRETATION: We found an unexpectedly high rate of loosening of the ulnar component, which was associated with intraoperative malpositioning of the prosthesis. The ulnar component of this prosthesis should not be inserted without cement in patients with rheumatoid arthritis.
Authors: Andrew King; Jonathan P Evans; Simon J Booker; James Cs Beazley; Robin Js Jones; William Jc Thomas; Christopher Smith Journal: Shoulder Elbow Date: 2018-05-25
Authors: Danielle Meijering; Alexander L Boerboom; Carina L E Gerritsma; Bertram The; Michel P J van den Bekerom; Marco van der Pluijm; Riemer J K Vegter; Sjoerd K Bulstra; Denise Eygendaal; Martin Stevens Journal: BMJ Open Date: 2021-05-05 Impact factor: 2.692
Authors: Daniëlle Meijering; Alexander L Boerboom; Fred Breukelman; Denise Eygendaal; Sjoerd K Bulstra; Martin Stevens Journal: BMC Musculoskelet Disord Date: 2019-09-06 Impact factor: 2.362
Authors: Jetske Viveen; Michel P J van den Bekerom; Job N Doornberg; Alesha Hatton; Richard Page; Koen L M Koenraadt; Christopher Wilson; Gregory I Bain; Ruurd L Jaarsma; Denise Eygendaal Journal: Acta Orthop Date: 2019-08-27 Impact factor: 3.717